Giovanna Abagnale (Sant’Antonio Abate / IT; Cava de Tirreni / IT), Andrea Coppola (Cava de Tirreni / IT; Naples / IT), Russo Maria (Cava de Tirreni / IT), Maria Gaudiello (Cava de Tirreni / IT; Naples / IT), Ilaria Angelone (Cava de Tirreni / IT; Naples / IT), Irma Vece (Cava de Tirreni / IT), Antonio Maschio (Cava de Tirreni / IT), Carmela Rescigno (Cava de Tirreni / IT)
Abstract text (incl. references and figure legends)
Clinical history: A 79-year-old woman came to our attentionbecause of a painful and non-reducible palpable mass in the right subcostal region, with nausea and vomiting.
Clinical findings: on blood tests, increased cholestasismarkers, white blood cells and PCR. A small, uncomplicatedepigatric hernia is also found on abdominal physicalexamination.
Investigation/results: The abdominal CT showed a distendedand dysmorphic gallbladder, extending beyond the abdominalwall, the presence of an endoluminous lithiasis of 1.5 cm and other minute lithiasis formations.
Therapy and progression: we decided for a laparotomic cholecystectomy surgery with median incision to repair the epigatric hernia at the same time. Upon exploration of the cavity, there is empty gallbladder loggia and gallbladder displaced towards the right side (Im.1).The body of the gallbladderengaged the abdominal wall with the fundus allocated in the subcutaneous tissue and containing a voluminous stone and numerous small contextual stones. Cholecystectomy has been performed and wall defects were repaired too.
Comment: This case report is of interest due to the rarity of the diagnosis of spontaneous herniation of gallbladder. In fact, in literature there are only three clinical cases of spontaneousherniation of gallbladder through the abdominal wall. Furthercases of gallbladder involvement concern incisional or parastomal hernias.
reference
•Pijpers M, Hazebroek EJ, Coene PP, Beerman H, Vroegindeweij D. Herniation of the gall bladder through the abdominal wall. Australas Radiol. 2007 Dec;51 Suppl:B296-8. doi: 10.1111/j.1440-1673.2007.01825.x. PMID: 17991089.
•El-Bakush A, Sherif K, Kambali S, Flathouse R, Quattromani F, Jumper C. Spontaneous ventral herniation of the gallbladder. Am J Med Sci. 2014 Jun;347(6):509. doi: 10.1097/MAJ.0b013e3182776a97. PMID: 23287655.
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