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Triple gallbladder with heterotopic gastric mucosa: a case report.
Ott, Leah; O'Neill, John; Cameron, Danielle; Callahan, Michael J; Grover, Amit; Fox, Victor L; Kim, Heung Bae; Lillehei, Craig; Cuenca, Alex G.
Afiliação
  • Ott L; Department of General Surgery, Boston Children's Hospital, 300 Longwood Avenue, Fegan 3, Boston, MA, 02115, USA.
  • O'Neill J; Department of Pathology, Boston Children's Hospital, Boston, MA, 02115, USA.
  • Cameron D; Department of General Surgery, Boston Children's Hospital, 300 Longwood Avenue, Fegan 3, Boston, MA, 02115, USA.
  • Callahan MJ; Department of Radiology, Boston Children's Hospital, Boston, MA, 02115, USA.
  • Grover A; Division of Gastroenterology, Hepatology, & Nutrition, Boston Children's Hospital, Boston, MA, 02115, USA.
  • Fox VL; Division of Gastroenterology, Hepatology, & Nutrition, Boston Children's Hospital, Boston, MA, 02115, USA.
  • Kim HB; Department of General Surgery, Boston Children's Hospital, 300 Longwood Avenue, Fegan 3, Boston, MA, 02115, USA.
  • Lillehei C; Department of General Surgery, Boston Children's Hospital, 300 Longwood Avenue, Fegan 3, Boston, MA, 02115, USA.
  • Cuenca AG; Department of General Surgery, Boston Children's Hospital, 300 Longwood Avenue, Fegan 3, Boston, MA, 02115, USA. alex.cuenca@childrens.harvard.edu.
BMC Pediatr ; 22(1): 52, 2022 01 20.
Article em En | MEDLINE | ID: mdl-35057772
ABSTRACT

BACKGROUND:

Triple gallbladder is a rare congenital anomaly of the biliary tract that can be associated with heterotopic tissue. Gallbladder triplication results from the failure of rudimentary bile ducts to regress during embryological development, and can be difficult to distinguish from Todani type II choledochal cysts and biliary duplication cysts. CASE PRESENTATION A 2-year-old patient presented to our institution with intermittent abdominal pain for 1 year. She had elevated transaminases with imaging concerning for a choledochal cyst. After assessment with magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography, she was diagnosed with a gallbladder multiplication and a common bile duct stricture. She underwent laparoscopic cholecystectomy, which confirmed the diagnosis of triple gallbladder. One of the three gallbladders demonstrated heterotopic gastric mucosa on final pathology, including at the cystic duct margin. Follow up testing with a technetium 99 m scan demonstrated a subtle focus of increased activity in the right upper abdomen at the expected location of the common bile duct, concerning for the presence of residual gastric mucosa. The patient remains well without abdominal pain.

CONCLUSIONS:

We describe the first case of heterotopic gastric mucosa in a triple gallbladder in a young patient presenting with chronic abdominal pain. We also demonstrate the safety and feasibility of laparoscopic cholecystectomy in young children with triple gallbladder. Finally, we propose an interdisciplinary approach to the management of common bile duct strictures in the setting of ectopic acid secretion, involving a combination of medical management, endoscopic intervention, and possible salvage laparoscopic Roux-en-Y hepaticojejunostomy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cisto do Colédoco / Vesícula Biliar Limite: Child / Child, preschool / Female / Humans Idioma: En Revista: BMC Pediatr Assunto da revista: PEDIATRIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cisto do Colédoco / Vesícula Biliar Limite: Child / Child, preschool / Female / Humans Idioma: En Revista: BMC Pediatr Assunto da revista: PEDIATRIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos