RESUMO
Primary gallbladder lymphoma is rare. Perforated cholecystitis due to primary gallbladder lymphoma and not related to chemotherapy has been unreported. We report the case of an 80-year-old woman presenting with an acute abdomen and clinical peritonitis. Her serum amylase was raised to 878 iu/l. Urgent computed tomography revealed generalised free fluid with a normal pancreas and was non-diagnostic as to the underlying pathology. An emergency laparotomy revealed bilious peritonitis with a necrotic patch on a distended gallbladder. A cholecystectomy was carried out and histology of the gallbladder revealed a marginal zone lymphoma.
Assuntos
Colecistite , Neoplasias da Vesícula Biliar , Vesícula Biliar , Hiperamilassemia , Linfoma , Abdome Agudo/etiologia , Idoso de 80 Anos ou mais , Colecistectomia , Feminino , Vesícula Biliar/patologia , Vesícula Biliar/cirurgia , Humanos , Necrose/etiologia , Peritonite/etiologia , Tomografia Computadorizada por Raios XRESUMO
Postcoital vaginal rupture is a rare but well documented complication of hysterectomy. Evisceration of the small intestine, vaginal bleeding and pelvic pain are common presenting features. We report the unusual case of vaginal rupture presenting with generalised peritonitis without vaginal evisceration.
Assuntos
Coito , Histerectomia/efeitos adversos , Peritonite/etiologia , Vagina/lesões , Adulto , Feminino , Humanos , Ruptura/etiologiaAssuntos
Acenocumarol/efeitos adversos , Anticoagulantes/efeitos adversos , Hemorragia Gastrointestinal/induzido quimicamente , Hematoma/induzido quimicamente , Doenças do Colo Sigmoide/induzido quimicamente , Sigmoidoscopia , Antifibrinolíticos/uso terapêutico , Transfusão de Sangue , Hidratação , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/terapia , Hematoma/diagnóstico , Hematoma/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Plasma , Doenças do Colo Sigmoide/diagnóstico , Doenças do Colo Sigmoide/terapia , Vitamina K/uso terapêuticoRESUMO
We report the case of an 81-year-old man with agenesis of the gall-bladder that presented with choledocholithiasis, obstructive jaundice, and very high CA 19-9 serum level (2765 U/ml). On ultrasound and CT scan, the gallbladder was not visualised and it was assumed shrunken and filled with gall-stones. After repeated unsuccessful endoscopic retrograde cholangiopancreatography, the patient was operated on for common bile duct (CBD) stones. At laparotomy the gall-bladder was not identified but a 3 cm long gall-stone was removed from the CBD. After decompression of the CBD all symptoms disappeared and the CA 19-9 returned to normal. We believe that this is the first report in the literature of gall-bladder agenesis presenting with high serum level of CA 19-9.
