胆囊炎症型恶性组织细胞瘤一例

病人,男,63岁.因间断右上腹隐痛3个月,右上腹包块10d于2006年2月22日入院.既往无胆绞痛等胆囊结石、胆囊炎病史.查体:体温36.1℃,一般情况可.     

胆囊海绵状血管瘤一例

患者,女,39岁,间断性右上腹隐痛1周.超声示胆囊占位性病变,于2007年6月18日收入院治疗.除觉右上腹隐痛外无其他不适,体检一般状况良好.皮肤及巩膜无黄染,心肺检查未见异常.腹平软,右上腹无压痛,未及肿块,肝、脾、双肾未触及.     

胆囊切除术后底体部残留1例

患者,女,56岁。因胆囊切除术后2年,反复右上腹隐痛不适1年入院。于2002年3月在当地乡镇医院行小切口胆囊切除术。术后恢复良好。1年后出现右上腹隐痛不适,但无畏寒、发热及黄疸等。B超检查提示胆囊结石、胆囊炎。入院查体：体温36．8℃;一般情况好,巩膜无黄染,腹平软,右上腹见一长2．5cm的经腹直肌切口疤痕;右上腹深压痛,     

胆囊缺如一例

患者,男,48岁,因"间歇性右上腹隐痛近3年"入院。患者于近3年来常在进食油腻食物后感觉右上腹隐痛,呈阵发性,伴右肩背部放射痛,无恶心、呕吐,无畏寒、发热,未见明显尿色加深、黄疸。腹痛可自行缓解,但反复发作。多     

胆囊缺如一例报告

患者，男，３９岁。因反复右上腹隐痛半年余，加重近三周于１９９４年１月３日入院。患者在半年前因进食油腻食物引发右上腹隐痛伴右背部放射痛，恶心，呕吐，无寒战，发热及黄疸。近三周发作频繁（约３～４天一次），否认手术外伤史。查体：皮肤粘膜无黄染，左侧颈肋，右...     

胆囊结核一例

患者男性,45岁.以右上腹间歇性隐痛、不适40余天主诉入院.40余天前起无明显原因右上腹隐痛,数日后巩膜轻度黄染,后渐消退.精神较差,有时盗汗.无发热、恶心、呕吐及腹泻.食欲尚可.无慢性咳嗽,否认肺结核史.在外院作MRI检查,诊断为"胰钩状突占位性病变".查体:T、P、R、BP在正常范围,较消瘦,心肺无阳性发现,腹部平软,肝、脾未触及,胆囊区轻度触痛.     

腹腔镜胆囊切除术后生物夹脱落再次腹腔镜手术一例

病人 ,女性 ,72岁 ,主因反复右上腹隐痛 1 0余年入院。Ｂ超提示胆囊颈部一约 1 0ｃｍ× 0 8ｃｍ息肉 ,术前检查未见手术禁忌。全麻下行腹腔镜胆囊切除术 (ＬＣ) ,术中见胆囊约 6 0ｃｍ× 3 5ｃｍ ,Ｃａｌｏｔ三角结构清晰。采用“三孔”法 ,按常规分离胆囊管、胆囊动脉 ,远端以钛夹夹闭 ,近端以生物夹夹闭 ,从中切断 ,近端各留生物夹 1枚。顺行切除胆囊 ,手术顺利。术野无渗液、胆漏 ,未置腹腔引流管。术后补液、抗炎治疗。术后第 1天 ,诉右上腹隐痛不适。查体右上腹轻压痛 ,余无明显异常。予对症处理。术后第 2天 ,诉右上腹隐痛并全腹胀…     

腹腔镜巨大胆囊结石胆囊切除术1例报告

正患者女,65岁,因反复发作右上腹隐痛不适20余年,加重1周入院。患者20余年前诊断为胆囊结石,无明显症状,未予治疗。近年右上腹疼痛发作频繁,1周前再次出现右上腹痛,呈持续性隐痛,无发热。患者自诉弯腰时有右上腹硬物感。入院查体右上腹轻压痛,无其他阳性体征。肝胆彩超示胆囊壁紧贴强回声,后方伴宽大声影,呈"三合征",弧形强回声长约5.7 cm,     

先天性胆囊缺如伴胆道结石

临床资料:常某,女,52岁.因反复右卜腹痛3年余,加重3 d.于2006年5月18日入院.诉右上腹呈间歇性隐痛,伴阵发性绞痛,并向右肩和腰背部放射.上述症状多次发作,追述与饮食无关.查巩膜、皮肤中度黄染,右上腹压痛,莫菲征阴性.病人曾在当地两家三级医院行B超检查,均未发现胆囊,CT提示胆囊未显影.人院后行消炎、利胆治疗.常规术前检查,未发现手术禁忌证.在连续硬膜外麻醉下行剖腹探查:肝肿大,淤肝,肝脏表面光滑,无胆囊,胆总管扩张约2 cm,内有结石.     

胆囊异位肝组织一例

患者,男,60岁.因反复间断右上腹隐痛20余年入院.体格检查:右上腹轻度压痛,肝区无扣击痛,Murphy's征(一).辅助检查:B超:胆囊未见异常.腹部CT:胆囊体部限局性增厚,范围2.0 cm×1.0cm界限清楚、向腔外突出,平扫CT值39HU,增强后中等强化CT值69 HU,CT诊断为胆囊腺肌增生症.     

Porcelain gallbladder is not associated with gallbladder carcinoma

The surgical management of porcelain gallbladder is based on studies performed in 1931 and 1962, which indicated a correlation between porcelain gallbladder and carcinoma. We sought to evaluate the characteristics of patients with porcelain gallbladder and the risk for gallbladder carcinoma. The medical records of 10,741 cholecystectomies performed between 1955 and 1998 were reviewed and recorded. The pathology slides were evaluated for evidence of calcification and gallbladder carcinoma. Fifteen (0.14%) of 10,741 specimens were porcelain gallbladders. Ten patients (67%) had symptoms suggestive of biliary colic or cholecystitis. Five (33%) were asymptomatic and diagnosed incidentally. All specimens demonstrated chronic cholecystitis and partial calcification of the gallbladder wall. Nine (60%) had cholelithiasis. None had gallbladder carcinoma by recent review of pathologic material. During this same period 88 (0.82%) patients had gallbladder carcinoma, none of which showed calcification of the wall. This report represents the largest modern review of porcelain gallbladders. No carcinoma was identified among patients with porcelain gallbladder. In addition no patient with gallbladder carcinoma had calcified gallbladder. With a better understanding of the natural history of the porcelain gallbladder the current management of these patients may change.     

Wandering gallbladder

A wandering gallbladder typically is attached to surrounding structures only by the cystic duct and its mesentery. Its characteristic propensity for torsion places it at risk for necrosis. A 70-year-old woman admitted to our hospital was found to have a wandering gallbladder. The possible clinical implications of this finding are discussed.