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Acute and chronic acalculous cholecystitis associated with aortic dissection.

Inagaki FF, Hara Y, Kamei M, Tanaka M, Yasuno M - J Surg Case Rep (2015)

Bottom Line: Histological study revealed fibrosis and hemosiderosis in the subserosal layer.The histological findings of these two patients are quite different: Case 1 is acute ischemic and Case 2 is chronic ischemic.History of aortic dissection could be a risk factor of acute and CAC due to relatively decreased splanchnic blood flow.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan Hepato-Biliary-Pancreatic Surgery Division, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan inagaki-tky@umin.ac.jp.

No MeSH data available.


Related in: MedlinePlus

(A) CT showed Stanford type B aortic dissection, the wall defect of gallbladder fundus and the local fluid collection. (B) Laparotomy showed the perforation of the gallbladder fundus. (C) Histological examination showed fibrosis and hemosiderosis in the subserosal layer (H&E ×100). (D) Fibrotic change of arterioles was dominant at the peripheral part of the gallbladder (H&E ×100).
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RJV101F2: (A) CT showed Stanford type B aortic dissection, the wall defect of gallbladder fundus and the local fluid collection. (B) Laparotomy showed the perforation of the gallbladder fundus. (C) Histological examination showed fibrosis and hemosiderosis in the subserosal layer (H&E ×100). (D) Fibrotic change of arterioles was dominant at the peripheral part of the gallbladder (H&E ×100).

Mentions: A 74-year-old male who complained of acute back pain was admitted to the hospital. He was diagnosed with Stanford type B aortic dissection and immediately underwent conservative treatment. On 65th hospital day, he suddenly developed high fever and severe right hypochondrial pain with local muscular defense, but laboratory data were within normal range. In the sonographic study, the gallbladder wall was not thickened, and neither gallstones nor biliary sludge was detected. However, contrast-enhanced CT demonstrated acalculous cholecystitis with the partial defect of the gallbladder fundus wall. Small fluid collection was found around the deficit (Fig. 2A). Laparotomy showed the perforation of the gallbladder fundus (Fig. 2B). Although no gallstone was found in the resected specimen, histopathological study revealed fibrosis and hemosiderosis in the subserosal layer (Fig. 2C and D). Intimal fibrotic change of arterioles was dominant at the peripheral part of the gallbladder. There was no pathological finding of vasculitis.Figure 2:


Acute and chronic acalculous cholecystitis associated with aortic dissection.

Inagaki FF, Hara Y, Kamei M, Tanaka M, Yasuno M - J Surg Case Rep (2015)

(A) CT showed Stanford type B aortic dissection, the wall defect of gallbladder fundus and the local fluid collection. (B) Laparotomy showed the perforation of the gallbladder fundus. (C) Histological examination showed fibrosis and hemosiderosis in the subserosal layer (H&E ×100). (D) Fibrotic change of arterioles was dominant at the peripheral part of the gallbladder (H&E ×100).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4522049&req=5

RJV101F2: (A) CT showed Stanford type B aortic dissection, the wall defect of gallbladder fundus and the local fluid collection. (B) Laparotomy showed the perforation of the gallbladder fundus. (C) Histological examination showed fibrosis and hemosiderosis in the subserosal layer (H&E ×100). (D) Fibrotic change of arterioles was dominant at the peripheral part of the gallbladder (H&E ×100).
Mentions: A 74-year-old male who complained of acute back pain was admitted to the hospital. He was diagnosed with Stanford type B aortic dissection and immediately underwent conservative treatment. On 65th hospital day, he suddenly developed high fever and severe right hypochondrial pain with local muscular defense, but laboratory data were within normal range. In the sonographic study, the gallbladder wall was not thickened, and neither gallstones nor biliary sludge was detected. However, contrast-enhanced CT demonstrated acalculous cholecystitis with the partial defect of the gallbladder fundus wall. Small fluid collection was found around the deficit (Fig. 2A). Laparotomy showed the perforation of the gallbladder fundus (Fig. 2B). Although no gallstone was found in the resected specimen, histopathological study revealed fibrosis and hemosiderosis in the subserosal layer (Fig. 2C and D). Intimal fibrotic change of arterioles was dominant at the peripheral part of the gallbladder. There was no pathological finding of vasculitis.Figure 2:

Bottom Line: Histological study revealed fibrosis and hemosiderosis in the subserosal layer.The histological findings of these two patients are quite different: Case 1 is acute ischemic and Case 2 is chronic ischemic.History of aortic dissection could be a risk factor of acute and CAC due to relatively decreased splanchnic blood flow.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan Hepato-Biliary-Pancreatic Surgery Division, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan inagaki-tky@umin.ac.jp.

No MeSH data available.


Related in: MedlinePlus