ABSTRACT
It is debatable among anatomists whether the Phrygian cap of the gall bladder is an anomaly or anatomic variation with an incidence of 4.0% reported. A 2-fold increase of 7.9% during a 5-year population study was observed in Lagos, Nigeria. A 48-year old male with minimal (non-acute) epigastric discomfort was referred for ultrasound after suspicious cholecystitis. On radiological evaluation, a double "Phrygian cap" was found by coincidence. There is no recent emphasis on double Phrygian cap study, thus it is reported for its rarity and difficulty in arriving at conclusive diagnosis. Common imaging choice is mostly by multi-slice CT for biliary aspects and appendages. Most Phrygian caps are asymptomatic with little or no pathologic consequence. Surgical intervention (cholecystectomy) for a Phrygian cap is only indicated in case of recurrent symptoms. To our knowledge, sparse anatomic and ultrasound literature exists on the Phrygian cap, thus the need for this rare case report
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Subject(s)
Humans , Male , Middle Aged , Gallbladder/abnormalities , Anatomic Variation , Nigeria/epidemiology , Gallbladder/surgery , Gallbladder/ultrastructure , Cholecystectomy/methods , Ultrasonography/methods , Longitudinal StudiesABSTRACT
In this paper, we report the results of histological and histochemical studies to differentiate between normal-term and growth-retarded placentas. Histology was based on Gordon and Sweet, while histochemistry was carried out by localizing G-6-PDH and LDH in the placentas. Thirty (30) placentas, 15 normal-term and 15 growth-retarded placentas, were collected from female patients recruited from the Antenatal Clinic of Dolu Specialist Hospital, Mafoluku-Oshodi, Lagos, Nigeria. Normal-term placentas were collected at the point of delivery by a consultant obstetrician in the presence of other co-researchers, after the consent of the patient had been sought. 1 cm thick portion of both normal and growth-retarded tissues for histological study were cut and processed for Gordon and Sweet staining to demonstrate reticulin fibres, while tissues for histochemical studies (G-6-PDH and LDH) were homogenized in cold 0.5 M sucrose solution. Data were comparatively analyzed using ANOVA statistics, with p<0.005. The result revealed that some places on the syncytial layer were discontinuous. Micro-vessels lying within the core of loose connective tissue were closely opposed to the syncytial trophoblast in IUGR case. Areas of collagen and fibrin deposition reflect ongoing repair of breaches of tissue border and epithelial integrity. The levels of G-6-PDH and LDH activities were lower in the growth- retarded placentas when compared with the normal term placentas. This difference was statistically significant at p<0.005. It is surmised that the placentas in IUGR indicate abnormalities of the maternal spiral arterioles, deregulated villous vasculogenesis, and abundant fibrin deposition is characteristics in IUGR. This shows that there is a link between enzymes of glucose metabolism in the terminal stage of the antenatal period in placental tissues with consequences for foetal growth and development
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