Abstract：
BACKGROUND: Moynihan\'s aphorism that \"gall stone is a tomb stone erected in the memory of the organism with in it\" is true even today. This case could be an example to reemphasise the forementioned axiom. We present here a case of Chronic Granulomatous Schistosomal cholecystitis which is an unusually rare cause of Cholecystitis and cholelithiasis, that too in a non-endemic area. The patient has never ever visited the known endemic zones of Schistosomiasis or Bilharziasis areas in India. In a way it could be the first case report of schistosomiasis in this area.
METHODS: A 59-year-old female patient presented to the Out-patient department of SMS&R, Sharda university, with right hypochondriac region pain and dyspepsia of six months duration. Investigation revealed Chronic Cholecystitis with Cholelithiasis. After a thorough workup the patient was taken up for Laparoscopic cholecystectomy, which was converted to open cholecystectomy due to adhesions and to prevent any iatrogenic injury to the biliary tree. Histopathological examination revealed Chronic Granulomatous Schistosomal Cholecystitis with Cholelithiasis. Patient did well in the post-operative period with anti-helminthic treatment.
CONCLUSIONS: Literature is still undecided whether the Schistosomal eggs deposition in the gallbladder can cause an episode of acute cholecystitis. However, a lithogenic outcome of schistosomiasis secondary to the induction of chronic granulomatous and fibrocalcific changes of the gallbladder and biliary ducts wall, seems probable.
METHODS: A 59-year-old female patient presented to the Out-patient department of SMS&R, Sharda university, with right hypochondriac region pain and dyspepsia of six months duration. Investigation revealed Chronic Cholecystitis with Cholelithiasis. After a thorough workup the patient was taken up for Laparoscopic cholecystectomy, which was converted to open cholecystectomy due to adhesions and to prevent any iatrogenic injury to the biliary tree. Histopathological examination revealed Chronic Granulomatous Schistosomal Cholecystitis with Cholelithiasis. Patient did well in the post-operative period with anti-helminthic treatment.
CONCLUSIONS: Literature is still undecided whether the Schistosomal eggs deposition in the gallbladder can cause an episode of acute cholecystitis. However, a lithogenic outcome of schistosomiasis secondary to the induction of chronic granulomatous and fibrocalcific changes of the gallbladder and biliary ducts wall, seems probable.
摘要：
背景：莫伊尼汉的格言是“胆石是在生物体的记忆中竖立的墓碑”，即使在今天也是如此。这种情况可能是重新强调上述公理的一个例子。我们在这里介绍一例慢性肉芽肿性血吸虫性胆囊炎，这是胆囊炎和胆石症的罕见原因，在非流行地区也是如此。患者从未去过印度已知的血吸虫病流行区或Bilharziasis地区。在某种程度上，这可能是该地区首例血吸虫病病例报告。
方法：一位59岁的女性患者被送到SMS&R的门诊部，Sharda大学,伴有右侧软骨下区疼痛和6个月的消化不良。调查显示慢性胆囊炎伴胆石症。经过彻底的检查，患者接受了腹腔镜胆囊切除术，由于粘连而转换为开放式胆囊切除术，并防止对胆道树的任何医源性伤害。组织病理学检查提示慢性肉芽肿性血吸虫性胆囊炎伴胆石症。患者在术后接受抗蠕虫治疗后表现良好。
结论：文献尚不确定胆囊内血吸虫卵沉积是否可引起急性胆囊炎发作。然而,继发于胆囊和胆管壁慢性肉芽肿和纤维钙化改变的血吸虫病的成岩结果，似乎很可能。
方法：一位59岁的女性患者被送到SMS&R的门诊部，Sharda大学,伴有右侧软骨下区疼痛和6个月的消化不良。调查显示慢性胆囊炎伴胆石症。经过彻底的检查，患者接受了腹腔镜胆囊切除术，由于粘连而转换为开放式胆囊切除术，并防止对胆道树的任何医源性伤害。组织病理学检查提示慢性肉芽肿性血吸虫性胆囊炎伴胆石症。患者在术后接受抗蠕虫治疗后表现良好。
结论：文献尚不确定胆囊内血吸虫卵沉积是否可引起急性胆囊炎发作。然而,继发于胆囊和胆管壁慢性肉芽肿和纤维钙化改变的血吸虫病的成岩结果，似乎很可能。
