Management of Adult Choledochal Cyst Coexisting with Gallbladder Carcinoma: A Case Report and Review of Literature
Choledochal cyst is a relatively rare condition. Even rarer is a choledochal cyst in association with a gallbladder carcinoma. This study reports a rare case of gallbladder carcinoma coexisting with a choledochal cyst in a Nigerian patient. Clinical records of the patient including preoperative eval...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | Nigerian Journal of Surgery |
| Subjects: | |
| Online Access: | http://www.nigerianjsurg.com/article.asp?issn=1117-6806;year=2016;volume=22;issue=1;spage=43;epage=47;aulast=Alatise |
| _version_ | 1811261321914613760 |
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| author | Olusegun Isaac Alatise Olatunbosun Ayokunle Oke Abdulrasheed Kayode Adesunkanmi Olaejinrin O Olaofe Christianah Mopelola Asaleye |
| author_facet | Olusegun Isaac Alatise Olatunbosun Ayokunle Oke Abdulrasheed Kayode Adesunkanmi Olaejinrin O Olaofe Christianah Mopelola Asaleye |
| author_sort | Olusegun Isaac Alatise |
| collection | DOAJ |
| description | Choledochal cyst is a relatively rare condition. Even rarer is a choledochal cyst in association with a gallbladder carcinoma. This study reports a rare case of gallbladder carcinoma coexisting with a choledochal cyst in a Nigerian patient. Clinical records of the patient including preoperative evaluation, intraoperative findings, and postoperative care were reviewed. A 38-year-old woman presented with the recurrent right upper abdominal pain of 3 years duration associated with progressive weight loss, anorexia, recurrent vomiting, as well as, low-grade fever with chills and rigors. Physical examination revealed an anicteric woman with tenderness in the right hypochondrium and a positive Murphy's sign. A combination of abdominal ultrasound and computed tomography scan suggested a Type IV choledochal cyst and a distended gallbladder with thickened walls containing a heterogeneous hyperdense mass. Preoperative serum alkaline phosphatase was elevated while endoscopic retrograde cholangiopancreatography was inconclusive. At laparotomy, extrahepatic biliary dilatation and enlarged, the nodular gallbladder was found with a diffusely fibrotic pancreas. Intraoperative cholangiogram confirmed Type IV choledochal cyst. Excision of the common bile duct and radical cholecystectomy was performed, and a Roux-en-Y hepaticojejunostomy. Histopathology confirmed the diagnosis of gallbladder adenocarcinoma. She had adjuvant chemotherapy and is presently on follow-up. No evidence of recurrence after 5 years of follow-up. A high index of suspicion is required to detect a combination of these two rare entities. When detected, both conditions should be surgically addressed at the same sitting, and when combined with adjuvant chemotherapy, may increase the chances of achieving a cure. |
| first_indexed | 2024-04-12T19:02:30Z |
| format | Article |
| id | doaj.art-bfb9eca4948346bfae98e18b790c524b |
| institution | Directory Open Access Journal |
| issn | 1117-6806 2278-7100 |
| language | English |
| last_indexed | 2024-04-12T19:02:30Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Nigerian Journal of Surgery |
| spelling | doaj.art-bfb9eca4948346bfae98e18b790c524b2022-12-22T03:20:07ZengWolters Kluwer Medknow PublicationsNigerian Journal of Surgery1117-68062278-71002016-01-01221434710.4103/1117-6806.169870Management of Adult Choledochal Cyst Coexisting with Gallbladder Carcinoma: A Case Report and Review of LiteratureOlusegun Isaac AlatiseOlatunbosun Ayokunle OkeAbdulrasheed Kayode AdesunkanmiOlaejinrin O OlaofeChristianah Mopelola AsaleyeCholedochal cyst is a relatively rare condition. Even rarer is a choledochal cyst in association with a gallbladder carcinoma. This study reports a rare case of gallbladder carcinoma coexisting with a choledochal cyst in a Nigerian patient. Clinical records of the patient including preoperative evaluation, intraoperative findings, and postoperative care were reviewed. A 38-year-old woman presented with the recurrent right upper abdominal pain of 3 years duration associated with progressive weight loss, anorexia, recurrent vomiting, as well as, low-grade fever with chills and rigors. Physical examination revealed an anicteric woman with tenderness in the right hypochondrium and a positive Murphy's sign. A combination of abdominal ultrasound and computed tomography scan suggested a Type IV choledochal cyst and a distended gallbladder with thickened walls containing a heterogeneous hyperdense mass. Preoperative serum alkaline phosphatase was elevated while endoscopic retrograde cholangiopancreatography was inconclusive. At laparotomy, extrahepatic biliary dilatation and enlarged, the nodular gallbladder was found with a diffusely fibrotic pancreas. Intraoperative cholangiogram confirmed Type IV choledochal cyst. Excision of the common bile duct and radical cholecystectomy was performed, and a Roux-en-Y hepaticojejunostomy. Histopathology confirmed the diagnosis of gallbladder adenocarcinoma. She had adjuvant chemotherapy and is presently on follow-up. No evidence of recurrence after 5 years of follow-up. A high index of suspicion is required to detect a combination of these two rare entities. When detected, both conditions should be surgically addressed at the same sitting, and when combined with adjuvant chemotherapy, may increase the chances of achieving a cure.http://www.nigerianjsurg.com/article.asp?issn=1117-6806;year=2016;volume=22;issue=1;spage=43;epage=47;aulast=AlatiseAdultcholedochal cystgallbladder cancerjaundicesurgeryNigeria |
| spellingShingle | Olusegun Isaac Alatise Olatunbosun Ayokunle Oke Abdulrasheed Kayode Adesunkanmi Olaejinrin O Olaofe Christianah Mopelola Asaleye Management of Adult Choledochal Cyst Coexisting with Gallbladder Carcinoma: A Case Report and Review of Literature Nigerian Journal of Surgery Adult choledochal cyst gallbladder cancer jaundice surgery Nigeria |
| title | Management of Adult Choledochal Cyst Coexisting with Gallbladder Carcinoma: A Case Report and Review of Literature |
| title_full | Management of Adult Choledochal Cyst Coexisting with Gallbladder Carcinoma: A Case Report and Review of Literature |
| title_fullStr | Management of Adult Choledochal Cyst Coexisting with Gallbladder Carcinoma: A Case Report and Review of Literature |
| title_full_unstemmed | Management of Adult Choledochal Cyst Coexisting with Gallbladder Carcinoma: A Case Report and Review of Literature |
| title_short | Management of Adult Choledochal Cyst Coexisting with Gallbladder Carcinoma: A Case Report and Review of Literature |
| title_sort | management of adult choledochal cyst coexisting with gallbladder carcinoma a case report and review of literature |
| topic | Adult choledochal cyst gallbladder cancer jaundice surgery Nigeria |
| url | http://www.nigerianjsurg.com/article.asp?issn=1117-6806;year=2016;volume=22;issue=1;spage=43;epage=47;aulast=Alatise |
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