ABSTRACT
Se presenta una variante anatómica de la vía biliar extrahepática, como lo es la verdadera duplicación vesicular. Las malformaciones congénitas vesiculares se categorizan en anormalidades posicionales y morfológicas, la duplicación vesicular está incluida en este último. La clasificación aceptada es la de Boyden. Basado en la relación del conducto cístico con el cuerpo vesicular describió la "vesica fellea divisa" (vesícula bilobulada que drena a un solo conducto cístico y comparte origen embriológico común) y "vesica fellea duplex" (verdadera duplicación vesicular, dos vesículas separadas con conductos císticos independientes, origen embriológico doble).
Subject(s)
Humans , Bile Ducts, Extrahepatic/abnormalities , Cholangiography , Bile Ducts, Extrahepatic/diagnostic imagingABSTRACT
We report here on an extremely rare case of duplicated extrahepatic bile ducts that was associated with choledocholithiasis, and this malady was visualized by employing the minimum intensity projection images with using multi-detector row CT. The presence of duplicated extrahepatic bile ducts with a proximal communication, and the ducts were joined distally and they subsequently formed a single common bile duct, has not been previously reported.
Subject(s)
Aged, 80 and over , Female , Humans , Bile Ducts, Extrahepatic/abnormalities , Choledocholithiasis/complicationsABSTRACT
The most commonly associated anomalies in patients with extrahepatic biliary atresia are cardiovascular, digestive and splenic defects. Of the cardiovascular anomalies, there are very few reports of biliary atresia with cardiomyopathy. We report the first case of a child with extrahepatic biliary atresia and restrictive cardiomyopathy. The patient was a 13-month-old boy diagnosed with extrahepatic biliary atresia at the age of 2 months, when he underwent laparotomy for definite diagnosis.Hepatic portoenterostomy was performed after confirmative cholangiogram. Recently, he developed severe cough and dyspnea, and his respiratory symptoms worsened. Chest radiograph showed cardiomegaly. Two- dimensional echocardiography showed marked biatrial enlargement. On M- mode echocardiogram, a slight increase in left ventricular dimension was seen in early diastole with a relatively good left ventricular function. Mitral inflow Doppler tracing showed an increased E-velocity (1.1 m/sec) with decreased deceleration time (75 m/sec), and increased E/A ratio (0.33). He was diagnosed as having restrictive cardiomyopathy with characteristic echocardiographic features.
Subject(s)
Humans , Infant , Male , Bile Ducts, Extrahepatic/abnormalities , Biliary Atresia/complications , Cardiomyopathy, Restrictive/complications , Lung/diagnostic imaging , Radiography, ThoracicABSTRACT
Os autores relatam um caso de dilataçäo cística congênita do colédoco em uma paciente de 7 anos, com história de dor abdominal do tipo cólica, cuja propedêutica laboratorial, assim como a radiografia simples de abdome, encontrava-se normal. A ultra-sonografia de abdome inicial evidenciava apenas colelitíase. Após tratamento da crise persistiu com a mesma sintomatologia por 9 meses, realizando mais 4 ultra-sonografias abdominais, que evidenciaram dilataçäo das vias biliares intra e extra hepáticas, sem colelitíase. A mesma foi submetida a laparotomia, que confirmou a presença de um grande cisto de colédoco, sendo o mesmo retirado e realizada uma anastomose bilio-digestiva, com boa evoluçäo no pós-operatório. Säo também revisados aspectos da sintomatologia, incidência e terapêutica.