Friday, 17 August 2018

CASE 508: GALLBLADDER PSEUDOTUMOR, Dr PHAN THANH HẢI, Dr NGUYỄN PHÚ HỮU, MEDIC MEDICAL CENTER, HCMC, VIETNAM.




Man 26 yo with subhepatic pain post prandial for a long time.
Ultrasound of abdomen:
US 1=  intercostal scan,  liver is normal,  biliary tract no dilated, and  gallbladder (GB)  adheres in liver border  by 2 portions, one near the GB neck  filling by bile fluid and GB fundus covered by a solid mass with  size of 3 cm which is.well limited inside GB.



US 2=  Color Doppler (CDI):  no thickening of GB wall, no hypervascular in GB wall, and  no detected vascular supply for this mass. But no posterior shadowing of this mass with  little enhancement of the posterior wall.


US 3= the GB fundus is covered by this mass but the wall is intact. This mass has no motion.  


Sonologist suggested  a tumor of  GB  like GB adenomyomatosis.

MRI of the biliary tract.:
MRI 1=   the biliary tract has no stone and GB is filled by tumor at GB fundus.


MRI 2 = GB  has 3 portions, the middle portion  is hyperdense and adherent to liver. The GB wall is thickening like tumor and enhanced with gado.


MRI 3 = crossed section of the GB at middle portion, GB wall thickening and GB lumen is small.


Radiolodist report   is tumor of GB.
Laparocholecystectomy was performed.
Photo 1 =   the GB wall is well intact.


Photo 2,3 =  inside content of  material of black pigment like coffee waste. The GB wall is normal without tumor.



Pathology report is pigment sludge and inflammation of GB.

Conclusion=  Pseudotumor of GB  by intragallbladder sludge tumefaction. 

Reference  pdf  case report.




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