Rare case of gallbladder mucocele causing gastric outlet obstruction treated with cholecystectomy

Loh, Wann Jia; Ng, Nick Zhi Peng; Kabir, Tousif; Chan, Chung Yip

doi:10.1016/j.ijscr.2019.03.013

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…Cases of appendiceal mucoceles causing mechanical bowel obstruction via extrinsic compression of the gastrointestinal tract have been reported 7 8. Gallbladder mucocele has been shown to cause gastric outlet obstruction through extrinsic compression of the duodenum 9. These pathologies are similar to our case, whereby the blind loop mucocele of the side-to-end anastomosis caused extrinsic compression of the rectum and mechanical bowel obstruction.…”

Section: Discussionsupporting

confidence: 75%

Blind loop mucocele of a side-to-end colorectal anastomosis as a rare cause of large bowel obstruction

et al. 2023

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Large bowel obstruction (LBO) after colorectal surgery draws wide differentials. To our knowledge, LBO due to blind colonic limb mucocele of a side-to-end colorectal anastomosis has not yet been described. We report a man in his late 50s presenting with pain, abdominal distension and constipation. He had extensive surgical history; notably, a side-to-end colorectal anastomosis was fashioned following Hartmann-type colostomy reversal. CT and MRI suggested a mucus-filled short blind colonic segment compressing the anastomotic site and causing LBO. Flexible sigmoidoscopy under general anaesthesia showed external rectal compression and lumen narrowing. Transrectal needle aspiration of the blind segment yielded 145 mL of mucoid fluid. The patient’s symptoms improved and he was discharged with outpatient Gastrografin enema and flexible sigmoidoscopy which confirmed successful blind segment emptying. This case highlights that blind colonic loop mucoceles in colorectal anastomosis can rarely cause obstruction, and endoscopic management is feasible when accurate diagnosis is confirmed on imaging.

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Section: Discussionsupporting

confidence: 75%

Blind loop mucocele of a side-to-end colorectal anastomosis as a rare cause of large bowel obstruction

et al. 2023

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“…Hydrops or mucocele of the gallbladder is characterized by abnormal mucus accumulation causing excessive distension of gallbladder. The pathogenesis involves inflammatory changes in the gall bladder, altered secretions, reduced bile flow, impaired gall bladder motility and altered absorption of water from the lumen of gallbladder (6).…”

Section: Discussion Discussionmentioning

confidence: 99%

A Rare Case of "Gastric Outlet Obstruction Secondary to Hydrops of Gallbladder" Caused by Recurrent Acalculous Cholecystitis: A Variant of Bouveret's Syndrome - A Rare Case and Review of Literature

Haji,

Renji John,

Elhassan

et al. 2023

SGO

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Introduction:We present an extremely rare case of gastric outlet obstruction (GOO) in a young male attributed to hydrops of the gallbladder resulting from recurrent episodes of acute acalculous cholecystitis. Remarkably, approximately one and half years prior to this presentation, the patient was diagnosed with confirmed acute acalculous cholecystitis and had tested positive for Covid 19 ,despite exhibiting no respiratory symptoms. Case report: While it is established that Patients with acute acalculous cholecystitis can develop gallbladder mucoceles due to the mechanism akin to mechanical cystic duct obstructions. This functional condition leads to a non-emptying, distended gallbladder where biliary mucus replaces bile salts (1). Conventionally, hydrops of the gallbladder is associated with prolonged blockage of the cystic duct, often caused by an impacted gallstone in neck/ cystic duct or a stricture in cystic duct. Bouveret's Syndrome, characterized by gastric outlet obstruction (GOO) results from the impaction of a large gallstone in the duodenum or pyloric channel, typically secondary to a cholecystoenteric fistula (2), is a recognized rare entity. However, our case stands apart as it elucidates an infrequently reported cause of GOO-hydrops of gall bladder inducing extrinsic compression of the duodenum/pylorus and this case also emphasizes the distinction from Bouveret's syndrome. Conclusions: This case underscores the importance of considering unusual etiologies in the diagnosis of GOO and emphasizes the need for timely recognition and intervention in such rare instances to ensure optimal patient outcomes. Additionally, we provide a comprehensive review of existing literature, highlighting the scarcity of reported cases with such relevant presentations.

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“…GSD is defined by the main occurrence of symptoms or complications caused by gallstones in the gallbladder and/or the bile ducts. Biliary colic (BC) is the main symptom of gallstone disease, and in addition, GSD patients often live with intolerance to fried or fatty foods (characterized by nausea, vomiting, and bloating) [ 15 ]. High-fat foods may strongly aggravate patients’ BC accompanying dyspeptic symptoms.…”

Section: Introductionmentioning

confidence: 99%

The cerebral mechanism underlying the acupoints with specific effect for gallbladder stone disease: protocol for a randomized controlled task-fMRI trial

Sun

Zhou

Jie

et al. 2021

Trials

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Background As it has been recorded in ancient Chinese classics, Yanglingquan (GB34) and Dannangxue (EX-LE6) are two important acupoints that can regulate the function of the gallbladder. Acupuncture at these two acupoints is considered particularly effective for gallbladder disease treatment, especially for alleviating gallbladder stone disease (GSD) symptoms that can be aggravated after intaking high-fat food. However, the superior effect between the two acupoints still needs to be further explored, as well as the underlying central mechanism has never been investigated to date. Methods and design Ninety participants diagnosed with GSD will be randomly divided into group A (acupuncture at GB34), group B (acupuncture at EX-LE6), and group C (acupuncture at non-acupoint) in a ratio of 1:1:1. All of them will receive a 30-min acupuncture treatment with fatty-food cues being presented before and after acupuncture. During the task, participants will be scanned by MRI and required to rate their desire for high-/low-fat food with an 11-point Likert scale. Additionally, the participants’ pain/discomfort sensation will be evaluated using the Numeric Rating Scale (NRS) at four timepoints, including before the 1st task fMRI scan, before and after acupuncture, and after the 2nd task fMRI scan. For both behavior and fMRI data, the ANOVA analysis will be conducted among three groups to testify the immediate effect of GB34 and EX-LE6. The post hoc t-test will be employed to further explore the superiority between acupuncture with GB34 and EX-LE6. Furthermore, correlation analyses will be conducted to investigate a possible correlation between neural changes and clinical data. Discussion In comparison to the non-acupoint, the results will firstly explore the superior effect between acupuncture with GB34 and EX-LE6 on GSD patients by observing their behavioral and neural response change to fatty-food cue, and then to investigate the underlying central mechanism. Trial registration Chinese Clinical Trial Registry ChiCTR2000034368. Registered on 3 July 2020.

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Rare case of gallbladder mucocele causing gastric outlet obstruction treated with cholecystectomy

Abstract: Highlights Gallbladder mucocele extremely rare etiology of GOO. Atypical symptoms made diagnosis difficult. Surgical intervention is suggested.

Cited by 5 publications

References 15 publications

Blind loop mucocele of a side-to-end colorectal anastomosis as a rare cause of large bowel obstruction

Blind loop mucocele of a side-to-end colorectal anastomosis as a rare cause of large bowel obstruction

A Rare Case of "Gastric Outlet Obstruction Secondary to Hydrops of Gallbladder" Caused by Recurrent Acalculous Cholecystitis: A Variant of Bouveret's Syndrome - A Rare Case and Review of Literature

The cerebral mechanism underlying the acupoints with specific effect for gallbladder stone disease: protocol for a randomized controlled task-fMRI trial

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