Ectopic prostatic tissue presenting as a urinary bladder polyp in a young male

Ectopic prostatic polyps are uncommon lesions, sometimes found in the lower urinary tract, particularly the posterior urethra. Ectopic prostatic tissue in the bladder is very uncommon. Until now, only 43 cases of this lesion have been reported in the English literature. Clinically and endoscopically these lesions are often mistaken for malignancy. We report a case of ectopic prostatic tissue at the bladder neck in a young male. Histopathology and immunohistochemistry confirmed the prostatic nature of the tissue. Since the entity is benign and unlikely to recur, we emphasize that urologists and pathologists need to be familiar with this to avoid misdiagnosis and unnecessary overtreatment.

Bilious mask: parasite masquerading as malignant gall bladder polyp

A 31-year-old woman, presenting with right upper quadrant pain, was suspected to have malignant gall bladder polyp based on MRI and CT scan findings. She underwent radical cholecystectomy with excision of bile duct and hepaticojejunostomy. Surprisingly, histology revealed parasitic remnants within the bile duct wall with no evidence of malignancy. A year later, this young woman suffers significant impairment of quality of life, perhaps an aftermath to the radicality of the surgery. Our case demonstrates a masquerade of ‘malignant biliary polyp’ by a parasite. This raises the need for extensive investigations such as endoscopic ultrasound guided biopsies, parasitic serology and positron emission tomography (PET) scans when patients present with probable malignant biliary lesions, even in difficult-to-access areas. A preoperative diagnosis might have averted an unnecessary major surgery in this young woman.

Incidence of double cystic artery: a clinical study

Background: A successful laparoscopic cholecystectomy is associated with the knowledge about anatomic structures and the congenital anomaly of the biliary tract. The aim of this study was to become familiar with vascular variations in laparoscopic cholecystectomy.Methods: This was a retrospective clinical study. The files of patients who underwent laparoscopic cholecystectomy due to benign gallbladder diseases were analyzed. The characteristics and complications of the patients with double cystic artery were recorded and examined.Results: A total of 360 patients, 76 males and 284 females were included in the study. The mean age was 51.2 (25-81). When the files of the patients were examined, it was found that double cystic arteries were detected during the operation in two male (2.63%) and nine female patients (3.16%). Gall bladder polyp was found as an indication for operation in one of 11 patients, while multiple gallbladder stones were found as an indication for operation in the other patients. The laparoscopic cholecystectomy was converted to conventional cholecystectomy in two from 11 patients (18.1%) with double cystic arteries due to bleeding. The mean duration of hospital stay in the patients with double cystic artery is 5.2 (3-11) days, and (2.7 days) longer compared to the patients without a double cystic artery.Conclusions: Cystic artery variations and other variations can coexist. Awareness of cystic artery variations can reduce the possibility of uncontrolled intraoperative bleeding, extrahepatic biliary injury, and switching to conventional cholecystectomy.

Gallbladder polyp

Gall bladder polyp เป็นภาวะที่พบได้บ่อย คาดว่าพบได้ประมาณร้อยละ 5 ของประชากรทั่วไป การวินิจฉัยที่สำคัญคือการตรวจด้วยอัลตร้าซาวนด์บริเวณถุงน้ำดีซึ่งต้องแยกให้ดีระหว่าง gall bladder polyp และ gallstone การรักษาที่สำคัญคือการผ่าตัดถุงน้ำดีออกเมื่อติ่งเนื้อมีขนาดเกิน 1 ซม ถ้าขนาดไม่เกินควรทำการติดตามดุว่าติ่งเนื้อมีขนาดใหญ่ขึ้นหรือไม่ โดยเฉพาะในช่วง 2 ปีแรก Figure 4 CT of upper abdomen แสดง multiple gallbladder polyps และ gallstones โดยลักษณะของ gallstones เป็น densed hyperdensity มากกว่า gallbladder polyps

Laparoscopic Cholecystectomy - A Cross Sectional Study

<strong>Aims and Objectives:</strong> 1. To study the clinical profile of patients undergoing laparoscopic cholecystectomy. 2. To study the post operative complications of laparoscopic cholecystectomy. <strong>Methodology:</strong> Ultrasound confirmed 48 cases of either sex admitted in department of surgery with cholelithiasis, gall bladder polyp, acute or chronic cholecystitis were included in this survey. These patients underwent laparoscopic cholecystectomy after preoperative preparation during August 2011-December 2013. <strong>Results:</strong> Highest age incidence was seen in 4^th decade with female preponderance. Most common presenting symptom was pain in abdomen followed by nausea, vomiting, dyspepsia and fever. Only 1 procedure was converted to open cholecystectomy with conversion rate of 2.08%. It was due to dense adhesions from chronic infection. The overall post-operative complication rate was 6.25% with wound infection being the most common occurring in 2 cases and prolonged ileus in 1 case. Chronic cholecystitis was the major histopathological diagnosis. The median post-operative stay in our study was 3 days. <strong>Conclusion:</strong> Chronic cholecystitis is the most common presentation of cholelithiasis with female pre-ponderance and incidence more in the 4^th decade. Laparoscopic cholecystectomy is safe and feasible treatment with less complication rate and early recovery.