A Rare Case of Gastric Heterotopic Pancreas with Cholecystoduodenal Fistula – A Case Report (original) (raw)

Heterotopic Pancreas of the Gallbladder Associated with Chronic Cholecystitis

2008

Context The presentation of heterotopic pancreas with cholecystolithiasis is exceedingly rare. Very few cases have been reported in the literature. The clinical significance so far is unclear. Case report We report a case of a 20-year- old female, suffering with biliary colic. On clinical examination abdomen was unremarkable. Ultrasonographic examination shows suspicion of a single stone in the gallbladder. Her liver functions were slightly abnormal. MRCP did not show any abnormality in the gallbladder and the common bile duct was of normal caliber. She underwent a successful laparoscopic cholecystectomy and her symptoms resolved. Pathological examination of the gallbladder revealed an area of heterotopic pancreas. Conclusion The preoperative diagnosis of heterotopic pancreas in the gallbladder is difficult. The significance of incidental finding of heterotopic pancreas in unclear and requires a systematic review of the subject.

An unusual cause of cholecystitis: heterotopic pancreatic tissue in the gallbladder

World Journal of Gastroenterology

Gallbladder localization of heterotopic pancreas (HP) is uncommon and very rarely gives rise to symptoms. Herein we report a case of HP found in the gallbladder neck presented with signs and symptoms of cholecystitis. The patient was a 40-year old male, suffering from epigastric pain, abdominal fullness and fever. On physical examination, the right upper abdomen was tender with a positive Murphy's sign. Ultrasonographic examination showed a hydropic gallbladder without stones and he underwent a cholecystectomy. Pathological examination revealed an intramural nodule (9 mm) in the neck region which is consisted of acini, ducts and islet cells of an aberrant pancreatic tissue. Although HP is encountered rarely in the gallbladder and is found incidentally during pathological studies, this case emphasizes that HP might cause symptoms and present clinically as cholecystitis. For this reason, in patients presenting with symptomatic gallbladder diseases, including cholecystitis without any other pathology, HP should be taken into consideration before it is diagnosed as "idiopathic''.

The Curious Case of a Missing Gallbladder: An Unusual Presentation of a Cholecystoduodenal Fistula

Avicenna Journal of Medicine, 2021

Large gallstones could erode through gallbladder wall to nearby structures, causing fistulas, gastric outlet obstruction and gallstone ileus. They typically occur in elderly patients with comorbidities carrying therapeutic challenges. We present a case of a middle-aged woman who was thought to have symptomatic cholelithiasis. Extensive adhesions precluded safe cholecystectomy. While hepatobiliary iminodiacetic acid scan and magnetic resonance imaging with cholangiopancreatography (MRI-MRCP) failed to visualize the gallbladder, computed tomography (CT) was consistent with cholecystoduodenal fistula. A very large gallstone was seen endoscopically in the duodenum, which was broken down into pieces using a large stiff snare.

Two Anomalies in One: A Rare Case of an Intrahepatic Gallbladder with a Cholecystogastric Fistula

Case reports in gastroenterology

The gallbladder can be situated in a variety of anomalous positions. An intrahepatic gallbladder - the second most common ectopic location of the gallbladder - is one that is completely embedded within the liver parenchyma. Described in the literature as early as 1935, intrahepatic gallbladders predominantly result from a developmental anomaly but in some instances have been reported to be secondary to chronic inflammation. The significance of an intrahepatic gallbladder lies in the fact that 60% of the cases are associated with gallstones and may present a challenge for the general surgeon during cholecystectomy and other biliary operations in addition to causing misdiagnosis on imaging. Intrahepatic gallbladders are unusual, but the incidence of an intrahepatic gallbladder with a cholecystogastric fistula is rare. Cholecystogastric fistulas commonly are a complication of long-term cholelithiasis or chronic cholecystitis with subsequent gallstone ileus. Herein, we present the case ...

Heterotopic Pancreas In Gall Bladder Associated With Chronic Cholecystitis- Is A Rare Combination

International journal of scientific and research publications, 2020

Heterotopic pancreatic tissue in the gallbladder is a very uncommon lesion, which is an incidental finding in most cases. We report here, a case of an 18-year-old, post puerperal female, suffering from right upper quadrant abdominal pain with a clinical diagnosis of chronic cholecystitis, in whom heterotopic pancreatic tissue was found in the gall bladder.

Heterotopic Pancreas in the Gallbladder: Case Report and Literature Review

Case Reports in Medicine, 2021

Introduction. Heterotopic pancreas (HP) is the congenital presence of pancreatic tissue outside its normal location in the absence of vascular and anatomical connection with the main pancreas. HP can affect any part of the gastrointestinal tract, and it is mostly encountered in the stomach. The gallbladder is a rare site of HP, and our literature review revealed that only 38 cases were reported. We present a case of HP in the gallbladder that was presented with a picture of acute cholecystitis. After the case presentation, we will discuss HP in the gallbladder by reviewing the literature. Case Presentation. A 49-year-old male presented to the emergency department complaining of progressively worsening right upper abdominal pain for the last 24 hours. After thorough history and physical examination, a provisional diagnosis of acute cholecystitis was made. Abdominal ultrasonography revealed a rim of edema surrounding the gallbladder wall with two stones impacted at the gallbladder nec...

Pancreatic heterotopia in the gall bladder: a case report and literature review

Pancreatic heterotopia in the gall bladder is a rare entity, with approximately 31 cases reported in English language literature until 2006; there are no Brazilian studies on the topic. As it is usually asymptomatic, the definitive diagnosis is made by the anatomopathological material excised due to common diseases of the organ, such as lithiasis, inflammatory processes, polyps and tumors. A case is reported of a 40-year-old female patient submitted to surgery with a diagnosis of lithiasic cholecystopathy. Ectopy was evidenced by the histological study, due to the presence of acinar and ductal components of the pancreas and gall bladder corpus. The authors used their own pathological classification for this ectopy, and recommended that this entity be included more frequently in the differential diagnosis of alithiasic cholecystopathy and intramural and exophytic lesions of the gall bladder.

Gallstone Ileus Caused by a Cholecysto-Duodeno-Colic Fistula, Case Report And Literature Review

ARS Medica Tomitana, 2017

Introduction: Complex cholecysto-duodeno-colic fistulas are an extremely rare complication that can occur in patients with cholelithiasis. The aim of this article is to present the case of a pacient with cholecystoduodeno- colic fistula manifested with biliary ileus in a patient known for many years with cholelithiasis. Case report: We present the case of a 62 y/o male that was admitted in our clinic with the diagnosis of gallstone ileus. Emergency surgical intervention was needed. Intraoperatively we discovered a cholecysto-duodenocolic fistula complicated with gallstone ileus. During the operation we practiced retrograde cholecystectomy, closure of the fistulous tract (duodenoraphy, coloraphy), enterotomy and extraction of the calculus located inside the small intestine. The postoperative evolution was favorable. Conclusions: Cholecysto-duodeno-colic fistulas complicated with gallstone ileus are an extremely rare complication that can occur in patients with gallstones. In case of ...