A Case of Acute Cholecystitis Caused by a Incarcerational Hyperplasic Polyp

The patient was a 52-year-old man who visited our hospital with the chief complaints of fever, abdominal pain and vomiting. Blood examinations revealed a marked increase in acute-phase reactants and increase in the biliary enzyme levels, and abdominal ultrasonography revealed gallbladder enlargement...

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Veröffentlicht in:Nippon Shokaki Geka Gakkai zasshi 2011/12/01, Vol.44(12), pp.1550-1557
Hauptverfasser: Hanawa, Hidetsugu, Yamamoto, Kazuhito, Teranishi, Nobuhisa, Kashiwabara, Moto, Futami, Ryouhei, Kiuti, Hiroyuki, Suzuki, Hideyuki
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container_end_page 1557
container_issue 12
container_start_page 1550
container_title Nippon Shokaki Geka Gakkai zasshi
container_volume 44
creator Hanawa, Hidetsugu
Yamamoto, Kazuhito
Teranishi, Nobuhisa
Kashiwabara, Moto
Futami, Ryouhei
Kiuti, Hiroyuki
Suzuki, Hideyuki
description The patient was a 52-year-old man who visited our hospital with the chief complaints of fever, abdominal pain and vomiting. Blood examinations revealed a marked increase in acute-phase reactants and increase in the biliary enzyme levels, and abdominal ultrasonography revealed gallbladder enlargement and gallbladder wall thickening. Plain abdominal computed tomography revealed a cystic lesion with an isodensity contour and low-density center, measuring approximately 2.0 cm in diameter, in the neck of the gallbladder. Based on these findings, acute cholecystitis due to a cystic lesion in the neck of the gallbladder was diagnosed. Because the inflammation was severe, emergency percutaneous transhepatic gallbladder drainage (PTGBD) was performed. The lesion was found to be a pedunculated tumor with a smooth surface by PTGBD imaging, and to be multilocular with a uniformly thickened wall by magnetic resonance imaging. Thus, we suspected a multilocular cystic benign tumor, and performed laparoscopic cholecystectomy. Examination of the resected specimen revealed that the tumor was pale red in color and pedunculated, with a smooth surface, and the histopathological findings were consistent with the diagnosis of a hyperplastic polyp of the metaplastic epithelial type. Acute cholecystitis due to incarceration of a hyperplastic polyp is rare. Therefore, we report our case as the first such case reported from Japan.
doi_str_mv 10.5833/jjgs.44.1550
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Blood examinations revealed a marked increase in acute-phase reactants and increase in the biliary enzyme levels, and abdominal ultrasonography revealed gallbladder enlargement and gallbladder wall thickening. Plain abdominal computed tomography revealed a cystic lesion with an isodensity contour and low-density center, measuring approximately 2.0 cm in diameter, in the neck of the gallbladder. Based on these findings, acute cholecystitis due to a cystic lesion in the neck of the gallbladder was diagnosed. Because the inflammation was severe, emergency percutaneous transhepatic gallbladder drainage (PTGBD) was performed. The lesion was found to be a pedunculated tumor with a smooth surface by PTGBD imaging, and to be multilocular with a uniformly thickened wall by magnetic resonance imaging. Thus, we suspected a multilocular cystic benign tumor, and performed laparoscopic cholecystectomy. Examination of the resected specimen revealed that the tumor was pale red in color and pedunculated, with a smooth surface, and the histopathological findings were consistent with the diagnosis of a hyperplastic polyp of the metaplastic epithelial type. Acute cholecystitis due to incarceration of a hyperplastic polyp is rare. 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Examination of the resected specimen revealed that the tumor was pale red in color and pedunculated, with a smooth surface, and the histopathological findings were consistent with the diagnosis of a hyperplastic polyp of the metaplastic epithelial type. Acute cholecystitis due to incarceration of a hyperplastic polyp is rare. Therefore, we report our case as the first such case reported from Japan.</abstract><pub>The Japanese Society of Gastroenterological Surgery</pub><doi>10.5833/jjgs.44.1550</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects acute cholecystitis
hyperplasic polyp
incarceration
title A Case of Acute Cholecystitis Caused by a Incarcerational Hyperplasic Polyp
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