Acute Flaccid Paralysis Accompanying West Nile Meningitis Ahmed ...
Acute Flaccid Paralysis Accompanying West Nile Meningitis Ahmed ...
Acute Flaccid Paralysis Accompanying West Nile Meningitis Ahmed ...
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Gallbladder Duplication with Dual Cholecystitis<br />
Rhodes, E, D.O., Parikh, S, D.O; Beniwal,JS, M.D.<br />
St. Joseph’s Regional Medical Center, Department of Surgery, Paterson, NJ<br />
Introduction: Gallbladder duplication, or dual gallbladder, is an uncommon<br />
entity encountered by surgeons. The approximate incidence of dual<br />
gallbladders is 1/4000; however, most are never seen due to their<br />
asymptomatic nature. When problems arise, such as cholecystitis, these<br />
anomalies are uncovered. Here we present the case of a female with<br />
gallbladder duplication along with dual cholecystitis, an exotic condition rarely<br />
seen in literature.<br />
Case: A 26 y/o female with 1 day of RUQ pain, intermittent in nature,<br />
associated with nausea/vomiting presented to the emergency department.<br />
After further work up, an ultrasound was done which was consistent with<br />
cholecystitis. Following this, an MRCP showed no distal obstruction. Next a<br />
HIDA scan was done in lieu of a dilated common bile duct on ultrasound,<br />
along with elevated liver function tests. The HIDA showed delayed gallbladder<br />
filling consistent with chronic cholecystitis. In the operating room, 2<br />
gallbladders were seen on examination. Each had a separate cystic duct and<br />
arterial supply and did not share a common wall. Both showed evidence of<br />
cholecystitis and were therefore removed. On final pathology one gallbladder<br />
showed evidence of acute inflammation while the other was identified as<br />
having chronic inflammation.<br />
Discussion: This case represents a rarity in the medical field. The patient<br />
had imaging not consistent with the actual disease. Imaging modalities can<br />
lead a surgeon astray if not taken within clinical context. With careful planning,<br />
a surgeon can be prepared for much of the aberrant anatomy encountered<br />
with typical preoperative symptoms.