背景技术胆囊在妊娠的第四周从肝憩室发展而来,也会产生肝脏,肝外胆管,和胰腺的腹侧部分。很少,胆囊有畸形或胚胎发育中断,导致先天性异常.胆囊中可能出现各种先天性异常。胆囊的真正或先天性憩室是一种罕见的实体,仅占Mayo诊所胆囊先天性异常的0.06%和胆囊切除术的0.0008%。这里的案例报告,我们报道了一例罕见的病例,即1名38岁女性患者在Jubail总医院的外科诊所就诊,出现右上象限(RUQ)疼痛伴餐后呕吐1个月.行腹腔镜胆囊切除术,胆囊组织送组织病理学检查。大体检查显示,在光学显微镜下,壁内有一个外袋粘膜,被证明由肌层和浆膜层组成。有趣的是,黄色肉芽肿性炎症局限于憩室,与涉及剩余胆囊的慢性炎症不同。基于上述发现,诊断为先天性憩室伴黄色肉芽肿性胆囊炎。结论与真正的憩室相关的胆囊通常被发现埋在肝脏中,导致胆囊切除术中的手术困难。因此,偶然异常的背景知识在指导外科医生选择最佳的管理方法中起着至关重要的作用。我们还讨论了伴随这些异常的相关并发症,例如非特异性的长期疾病,无结石性胆囊炎,胆囊炎和胆石症,复发性胆管炎,和胆囊癌。
BACKGROUND The gallbladder develops from the hepatic
diverticulum during the fourth week of gestation, which also give rise to the liver, extrahepatic biliary ducts, and ventral part of the pancreas. Infrequently, the gallbladder has malformation or disruption in embryogenesis, leading to congenital anomalies. There are various congenital anomalies that can arise in the gallbladder. True or congenital
diverticulum of the gallbladder is a rare entity that accounts for only 0.06% of gallbladder congenital anomalies and 0.0008% of cholecystectomies at the Mayo Clinic. CASE REPORT Herein, we report a rare case of a 38-year-old woman who presented to Jubail General Hospital\'s surgery clinic with right upper-quadrant (RUQ) pain associated with vomiting after meals for 1 month. Laparoscopic cholecystectomy was done and gallbladder tissue was sent to histopathology. Gross examination revealed an outpouching mucosa within the wall that was proven to consist of muscularis and serosa layers under light microscope. Interestingly, xanthogranulomatous inflammation was confined to the
diverticulum, unlike the chronic inflammation involving the remaining gallbladder. Based on the above findings, the diagnosis of congenital
diverticulum with xanthogranulomatous cholecystitis was made. CONCLUSIONS Gallbladders associated with a true
diverticulum are uncommonly found to be buried in the liver, leading to surgical difficulties during cholecystectomy. Therefore, background knowledge of occasional anomalies plays a crucial role in guiding the surgeon to choose the optimal method of management. We also discuss the associated complications that accompany these anomalies, such as non-specific prolonged ailments, acalculous cholecystitis, cholecystitis and cholelithiasis, recurrent cholangitis, and carcinoma of the gallbladder.