RESUMO
INTRODUCTION: Xanthogranulomatous cholecystitis [XGC] is an unusual form of chronic cholecystitis characterised by marked thickening of the gallbladder wall and accumulation of lipid laden macrophages. It is frequently misdiagnosed preoperatively with gallbladder carcinoma. The aim of this study was to assess the preoperative clinical and radiological characteristics, operative findings and histological features of patients with XGC based on the experience of a single institution. In addition a literature search was performed to identify previously reported cases
PATIENTS AND METHODS: This retrospective study was conducted from January 2009 to December 2014. 1,989 consecutive patients who underwent elective cholecystectomy at the Surgical Unit-I, Liaquat University Hospital, Jamshoro, Pakistan were included in this study. Seventeen patients were identified to have XGC on histopathology
RESULTS: Seventeen [0.8%] cases of XGC were identified in 1,989 cholecystectomy specimens performed. The female to male ratio was 7.5:1. The average age in our series was 51.6 [range from 18 to 77 years]. Two [11.7%] cases, suspected of malignancy during preoperative work-up, were reported as XGC on histopathology
CONCLUSION: Preoperative differentiation between XGC and carcinoma of the gallbladder remains challenging due to similarities in clinical presentation, radiological and operative findings
In view of this there should be a low threshold for conversion from a laparoscopic to an open procedure
RESUMO
Objectives: to determine the prevalence of Helicobacter pylori infection in patients with perforated peptic ulcer
Patients and methods: this prospective study was conducted in the Department of Surgery, [Surgical Unit-II], Liquate University of Medical and Health Sciences, Jamshoro. All patients were evaluated by full history, clinical examination and relevant laboratory investigations including. X-ray chest and abdomen, ultrasound abdomen, serum anti H-Pylori, biopsy and histopathology for detection of helicobacter pylori infection and perforation. The data was collected through pre-designed proforma and analyzed by SPSS version 10.00
Results: during study period 75 patients were diagnosed as case of perforated peptic ulcer. Male [73%] outnumber female [27%]. Majority of patients were more than 30 years of age with mean age of 44.6 years SD +/- 9.89. The serological test for helicobacter pylori was positive in all 75 cases; however histopathology of biopsy yields H. pylori in 50 [66.6%] cases. On exploratory laparotomy perforated duodenal ulcer was found in 50 [67%] patients while 25[33%] patients had perforated gastric ulcer
Conclusion: the biopsy proven prevalence of perforated peptic ulcer, one of the life threatening complications of H. Pylori, was is 67% in this study