2005, Number 12
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Ginecol Obstet Mex 2005; 73 (12)
Complicated pregnancy with lithiasis and resectable gallbladder cancer. A case report and literature review
Olivas MG, Mesina SJ, Mata OVM, Hernández M
Language: Spanish
References: 15
Page: 661-665
PDF size: 85.07 Kb.
ABSTRACT
Pregnancy complicated with gallbladder disease stone has an incidence of 2-14%, and more than 30% of patients do not respond to medical treatment; therefore, in order to reduce the morbidity and mortality in fetus and mother, surgical management would be required. The current use of ultrasound of high resolution has facilitated the diagnosis and also, in the present clinical case, this imaging modality allowed us to suspect the unusual diagnosis reported, that corresponds to a female of 34 years old with 33 weeks of pregnancy, complicated with symptomatic gallbladder disease stone, whose pain was intractable at the expectant management. The clinical diagnosis was corroborated by ultrasound and the report was: lithiasis, biliary sludge and an intragallbladder image of bilobular polypoid. The patient was submitted to cholecystectomy by laparotomy, whose histopathologic findings were: cholelithiasis and in situ gallbladder adenocarcinoma with an exophytic growing variety. The purposes of this article are to report a case and to review the literature.
REFERENCES
Maringhini A, Ciambra M, Baccelliere P, Raimondeo M, Orlando A, Tiné F, et al. Billiary sludge and gallstones in pregnancy: Incidence, risk factors and natural history. Ann Intern Med 1993;119:116-20.
Bravermann D, Herbet D, Goldstein R, Persitz E, Eylath U, Jacobsohn WZ. Postpartum restoration of pregnancy induced cholecystoparesis and prolonged intestinal transit time. J Clin Gastoenterol 1988;10:642-6.
Alba-Quintanilla F, Posadas-Robledo FJ. Evaluación ultrasónica de la vesícula durante el embarazo. Ginecol Obstet Mex 1997;65:39-42.
Swisher SG, Schmitt PJ, Hunt KK, et al. Biliary disease during pregnancy. Am J Surg 1994;168:576-9.
Sungler P, Heinrman PM, Seiner H, Waclawiczek HW. Laparoscopic cholecystectomy for gallstones complications during pregnancy. Surg Endos 2000;14(3):267-71.
Silecchia G, Raparelli L, Jover-Navalon JM, et al. Laparoscopy cholecystectomy and incidental carcinoma of the extrahepatic biliary tree. JSLS 2002;6:339-44.
Aristi UG, Pérez PM, Virgilia SM. Carcinoma de vesícula: una neoplasia subestimada. Rev Med Hosp Gen Mex 1999;62:94-101.
Wistuba II, Ashfaq R, Maitra A, Alvarez H, Riquelme E, Gazdar FA. Fragile histidine triad gene abnormalities in the pathogenesis of gall bladder carcinoma. Am J Pathol 2002;160:2073-9.
Lynn J, Williams L, O Brien J, Wittenberg J, Egdahl RH. Effects of estrogen upon bile. Ann Surg 1973;178:514-24.
Nakajima S, Kayba M, Harada T. Indication of gallbladder cancer for laparoscopic cholecystectomy. Surg Endos 1994;8:617-9.
Khan ZR, Neugut AI, Chabot JA. Risk factors for biliary cancers. Am J Gastroenterol 1999;94:149-52.
American Joint Committee on Cancer: AJCC, Cancer Staging Manual. Extrahepatic bile ducts. 5th ed. Philadelphia: Lippincott-Raven Publishers, 1997;pp:109-13.
Kopelson G, Galdabini J, War Shaw AL. Patterns of failure after curative surgery for extrahepatic biliary tract carcinoma: Implications for adjuvant therapy. Int J Radiat Oncol Biol Phys 1981;7:413-17.
Gallardo JO, Rubio B, Harbs H. Avances en cáncer de vesícula biliar. Rev Chil Cancerología y Hematología 2000;10:79-86.
Cortés A, Botero MP, Carrascal E, Bustamante F. Carcinoma insospechado de vesícula biliar. Colo Med 2004;35:18-21.