Hartmann pouch herniation in Calot’s triangle: A case report
| Autor: | Malek A. Al-Omari, Ra’ed Al-Jarrah, Tariq Almnaizel, Abdulhamid M. Al-Abadi, Tawfiq Alnawafleh, Eman A. Al-Oudat |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Calot’s triangle Gallbladder Stone Article 03 medical and health sciences Laparoscopic cholecystectomy 0302 clinical medicine medicine Hepatology Hartmann pouch business.industry General surgery Gastroenterology Emergency department medicine.disease medicine.anatomical_structure Biliary tract 030220 oncology & carcinogenesis Cholecystitis Cystic duct 030211 gastroenterology & hepatology Surgery Presentation (obstetrics) Differential diagnosis Complication business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • There are many atypical anatomic structural variations of the biliary tree. • The anatomical variations can be diagnosed either intra-operatively or pre-operatively. • Surgeon’s experience and knowledge are essential to form the best surgical decision. • A second opinion of a hepatobiliary surgeon decreases avoidable complex injury to biliary tract in selective cases. • Fine handling of hepatocystic triangle and skeletonization of porta hepatis are the main principles of surgery. Introduction Laparoscopic cholecystectomy is one of the most frequent operations performed around the world. Some pathological findings are particularly rare and difficult to diagnose preoperatively. Here, we report a case of a patient who presented to our hospital with calculus cholecystitis with a unique Intraoperative finding of Hartmann pouch herniation through hepatocystic triangle. The aim of the study is to consider Hartmann pouch herniation as a rare differential diagnosis of gallbladder stone complication. Presentation of case We present a 48-year-old male who came to our emergency department complaining of constant epigastric abdominal pain lasting 3 h with vomiting. Utilizing chemistry laboratory studies and radiological studies, the final diagnosis was acute calculus cholecystitis. Early laparoscopic cholecystectomy was done and revealed Hartmann pouch herniation through the Calot’s triangle. This herniation resulted in strangulation of the Hartmann pouch and displacement of the cystic duct and artery anteriorly. Discussion The biliary tract is liable for congenital anomalies. These anatomical variations can be diagnosed either intra-operatively or pre-operatively using radiological imaging. Hartmann pouch herniation is a new finding that we encountered in this case. Conclusion Profound surgeons’ anatomical knowledge is essential for the safety of patients, especially for hepatobiliary surgeries due to the wide variations in normal and pathological anatomy. Using critical view of safety can decrease avoidable complications. Consulting specialized hepatobiliary surgeon is preferred when dealing with such cases. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|