RESUMO
We report a case of gallbladder hernia into the lesser sac through the foramen of Winslow. The patient was a 90-year-old woman, admitted to hospital with obstructive jaundice. Computed tomography (CT) showed a left-deviated and remarkably enlarged gallbladder dragging the liver, and a dilated intrahepatic bile duct. The deviated gallbladder was thought to compress the common bile duct, causing the obstruction. Laparoscopic examination revealed gallbladder herniation into the lesser sac without a floating gallbladder; thus, we performed laparoscopic cholecystectomy. Herniation of the gallbladder is the rarest of all internal hernias and most reported cases have involved a floating gallbladder. The case we report here is therefore considered especially unusual.
Assuntos
Doenças da Vesícula Biliar/patologia , Doenças da Vesícula Biliar/cirurgia , Hérnia/patologia , Herniorrafia/métodos , Cavidade Peritoneal/patologia , Idoso de 80 Anos ou mais , Ductos Biliares Intra-Hepáticos/diagnóstico por imagem , Ductos Biliares Intra-Hepáticos/patologia , Colecistectomia Laparoscópica , Colecistografia , Colestase Intra-Hepática/etiologia , Feminino , Vesícula Biliar/patologia , Doenças da Vesícula Biliar/complicações , Doenças da Vesícula Biliar/diagnóstico , Hérnia/complicações , Hérnia/diagnóstico , Humanos , Icterícia Obstrutiva/etiologia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
A58-year-old man suffered from acute disseminated encephalomyelitis (ADEM) after dengue fever. ADEM has not been described as the cause of neurological complications in dengue fever. However, the increasing use of magnetic resonance imaging in endemic areas may help to identify ADEM as being responsible for neurological complications in dengue fever.
