Management of Adult Choledochal Cyst Coexisting with Gallbladder Carcinoma: A Case Report and Review of Literature
| Autor: | Olatunbosun Ayokunle Oke, Christianah M Asaleye, Olusegun I. Alatise, Abdulrasheed Kayode Adesunkanmi, Olaejinrin O Olaofe |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
choledochal cyst medicine.medical_specialty medicine.medical_treatment lcsh:Surgery Nigeria Case Report 030230 surgery Adult choledochal cyst gallbladder cancer jaundice surgery Nigeria jaundice gallbladder cancer surgery 03 medical and health sciences 0302 clinical medicine Laparotomy Medicine Choledochal cysts Gallbladder cancer Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test Common bile duct business.industry Gallbladder lcsh:RD1-811 medicine.disease Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Chills Cholecystectomy medicine.symptom business |
| Zdroj: | Nigerian Journal of Surgery : Official Publication of the Nigerian Surgical Research Society Nigerian Journal of Surgery; Vol 22, No 1 (2016); 43-47 Nigerian Journal of Surgery, Vol 22, Iss 1, Pp 43-47 (2016) |
| ISSN: | 2278-7100 1117-6806 |
| Popis: | Choledochal cyst is a relatively rare condition. Even rarer is a choledochal cyst in association with a gallbladder carcinoma. This study reports a rare case of gallbladder carcinoma coexisting with a choledochal cyst in a Nigerian patient. Clinical records of the patient including preoperative evaluation, intraoperative findings, and postoperative care were reviewed. A 38-year-old woman presented with the recurrent right upper abdominal pain of 3 years duration associated with progressive weight loss, anorexia, recurrent vomiting, as well as, low-grade fever with chills and rigors. Physical examination revealed an anicteric woman with tenderness in the right hypochondrium and a positive Murphy's sign. A combination of abdominal ultrasound and computed tomography scan suggested a Type IV choledochal cyst and a distended gallbladder with thickened walls containing a heterogeneous hyperdense mass. Preoperative serum alkaline phosphatase was elevated while endoscopic retrograde cholangiopancreatography was inconclusive. At laparotomy, extrahepatic biliary dilatation and enlarged, the nodular gallbladder was found with a diffusely fibrotic pancreas. Intraoperative cholangiogram confirmed Type IV choledochal cyst. Excision of the common bile duct and radical cholecystectomy was performed, and a Roux-en-Y hepaticojejunostomy. Histopathology confirmed the diagnosis of gallbladder adenocarcinoma. She had adjuvant chemotherapy and is presently on follow-up. No evidence of recurrence after 5 years of follow-up. A high index of suspicion is required to detect a combination of these two rare entities. When detected, both conditions should be surgically addressed at the same sitting, and when combined with adjuvant chemotherapy, may increase the chances of achieving a cure.Keywords: Adult, choledochal cyst, gallbladder cancer, jaundice, surgery, Nigeria |
| Databáze: | OpenAIRE |
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