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Friday, 15 June 2018

CASE 498: GALLBLADDER ABSCESS, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

WOMAN ONE MONTH  AGO WITH  EPIGASTRIC PAIN AND  LOCATED AT MURPHY POINT AND FEVER.
  
ULTRASOUND  DETECTED ONE MASS  IN HEPATIC BORDER ,  SIZE 5CM  ( US 1).


US  OBLIQUE SCANNING OF THIS MASS  IS THICKENING BORDER LIKE  AVOCADOS FRUID ( US 2).


US 3 : LIVER SCANNING OF THIS TUMOR  MADE BENDING   HILUS OF LIVER.


US 4 : ELASTOSCANNING OF THE WALL CODED  HARD PATTERN.

THERE WAS NO BLOOD INSIDE MASS AND ONE STONE  IN THE WALL OF THIS MASS  MADE THOUGHT IT GALLBLADDER.



CT SCAN WITH CE= CT1 : CROSSED SECTION  OF THIS
HYPODENSE MASS.


CT2 , CT3 :   FRONTAL VIEWS.




MRI OF ABDOMEN SHOWED THIS CYSTIC MASS, WITH ITS
VERY THICKENING WALL.


BLOOD TESTS = WBC:  1,9 K  WITH  8.9% NEUTRO,  CRP  96.8 ng/mL.
PRE OPERATIVE  DIAGNOSIS IS GALLBLADDER  ABSCESS WALLED OFF DUE TO STONE.
PHOTO OF MACROSCOPIC SPECIMEN IN   OPERATION FOR REMOVING GB ABSCESS.


  
CONCLUSION =  INFLAMMED GALLBLADDER NECROSIS BY STONE CAUSED OBSTRUCTION OF THE NECK OF GALL BLADDER.

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