The diagnosis of gallbladder agenesis: two cases report.

Congenital absence of the gallbladder is an extremely rare embryological aberration that is frequently mistaken for cholecystolithiasis; the aim of this study is to investigate the diagnostic methods for agenesis of the gallbladder. Two surgically confirmed gallbladder agenesis cases in our hospital and 75 cases of gallbladder agenesis reported in the literature in China were reviewed. It is extremely difficult to make a correct diagnosis of gallbladder agenesis before operation. When suspected, it may be confirmed by ERCP and MRCP. Interoperate, if no gallbladder can be found during laparoscopy, open surgery should be immediately performed Clinician's understanding of this disease is of great help in avoiding unnecessary surgical exploration and minimizing the risk of complication. Patients with gallbladder agenesis can be classified into two new types, I: Symptomatic, II: Asymptomatic. Type I can be divided into two subtypes: I a with fatal malformations and I b without fatal malformations.

Management of bile duct injuries combined with accessory hepatic duct during laparoscopic cholecystectomy.

Bile duct injuries (BDIs) are difficult to avoid absolutely when the biliary tract has a malformation, such as accessory hepatic duct. Here, we investigated the management strategies for BDI combined with accessory hepatic duct during laparoscopic cholecystectomy.

Ectopic adrenal cortical adenoma in the gastric wall: case report.

Ectopic adrenal cortical neoplasms are extremely rare. Ectopic adrenocortical tissue can be found in locations such as the celiac axis, the broad ligament, the adnexa of the testes, and the spermatic cord; however, they rarely involve the stomach. We report an unusual case of a patient with an ectopic adrenal cortical adenoma in the gastric wall. The patient was a 72-year old female admitted to our hospital with upper abdominal discomfort. Physical examination revealed tenderness below the xiphoid process. Both computed tomography and fibergastroscopy revealed a mass on the lesser curvature side of the gastric antrum; it was initially diagnosed as a gastric stromal tumor. After adequate preparation, the patient underwent surgery. During the procedure, we found a 30 mm × 30 mm mass with medium density in the lesser curvature near the gastric antrum within the serosa. Following immunohistochemistry examination, we corrected the diagnosis to an ectopic adrenal cortical adenoma; the tumor was nonfunctional.

Treatment of hilar cholangiocarcinoma of Bismuth-Corlette type III with hepaticojejunostomy.

AIM OF THE STUDY: The present study aims to explore the value of application of hepaticojejunostomy in surgical treatment of Bismuth-Corlette type III hepatic hilar cholangiocarcinoma. MATERIAL AND METHODS: The clinical data of hepaticojejunostomy in 6 patients with Bismuth-Corlette type III hepatic hilar cholangiocarcinoma from January 2008 to October 2011 were retrospectively analyzed. There were 5 males and 1 female, aged 45-69 years, on average 58 years old. There were 3 cases of Bismuth-Corlette type IIIa and 3 cases of Bismuth-Corlette type IIIb. RESULTS: The 6 patients all successfully underwent hepaticojejunostomy, with operation time of 160-310 min, on average 210 ±28 min. One patient suffered a small amount of bile leakage (3-20 ml) and his drainage tube was taken out after being cured with conservative treatment for 18 days. Three patients showed postoperative mild increases of aspartate aminotransaminase (AST), alanine transaminase (ALT) and AKP, which were improved after drug treatments. There was no biliary stricture in the 6 patients after follow-up for 3-18 months. CONCLUSIONS: Hepaticojejunostomy was simple and flexible, with a good effect on biliary reconstruction of Bismuth-Corlette type III hepatic hilar cholangiocarcinoma. It solved the difficulties in multiple choledochojejunostomy, and with less complications; therefore, it is worth being popularized.

Primary segmental and multiple adenocarcinomas of the small bowel.

Small bowel tumors are rare; most are single and located in the duodenum. When a patient presents with unreasonable abdominal pain and distension, with normal upper gastrointestinal endoscopy and colonoscopy, it is important to consider this disease. Here, we report a case of segmental and multiple adenocarcinoma of the small bowl presenting with unreasonable abdominal pain and distension in a 76-year-old woman, and provide a brief review on this subject. Our report highlights the fact that segmental and multiple small bowel tumors are very rare and the clinical characteristics are generally vague and nonspecific.

Intestinal malrotation associated with colon cancer in an adult: report of a case.

Intestinal malrotation is a congenital anomaly of intestinal rotation and fixation that generally becomes symptomatic during the neonatal period. However, it rarely occurs in adulthood, and synchronous colon cancer is even rarer. This report presents the case of a 45-year old man who suffered from intestinal malrotation associated with colon cancer.