Gallbladder Ascariasis: A Rare Case

21 yaşında kadın hasta 6 aydır süren sağ üst kadran ağrısı nedeni ile acil servise başvurdu. Abdominal US'de safra kesesi hidropik (89x40 mm) olup duvar kalınlığı normaldi. Lümeni içerisinde hiperekojen, solid nodülasyonlar gösteren kese lümeni boyunca devam eden lineer ondülan hiperekojen membranöz yapı mevcuttu. MRKP'de safra kesesi içerisinde ondülan, T2A da hipointens kurvilineer görünüm mevcuttu (Şekil 2AB) ve safra kesesi askariazisini düşündürdü. Ayrıca safra kesesi boyun kesiminde T1A ve T2A da hipointens taş mevcut idi. US'de ve MRKP'de taşın da olması nedeni ile hastaya 10 gün sonra elektif şartlarda laparoskopik kolesistektomi operasyonu yapıldı. Patolojik spesimende de Ascaris lumbricoides ispatlandı. Safra kesesi askariazisi nadir karşılaşılan bir durum olup, sebebi Ascaris lumbricoides'tir. Safra sistemi askariazisi üzerinde yayınlanmış birçok çalışma olup bunların çoğunluğu primer modalite olan ultrasonografi ile dökümente edilmiştir. Safra sistemi askariazisinin Manyetik Rezonans Kolanjiopankreatografi (MRKP) bulguları ise nadiren bildirilmiştir. MRKP, safra kesesi ve safra yolları askariazisini gösteren noninvaziv özgün bir yöntemdir.

Nadir Bir Olgu: Safra Kesesi Askariazisi

A 21 year-old female patient admitted to the emergency room complaining of right upper quadrant pain that had lasted for 6 months. The abdominal USG revealed hydropic gallbladder (89x40 mm) and the wall thickness was in normal limits. There was a linear undulant hyperechogenic membranous structure that was located along the bladder lumen with hyperechogenic and solid nodulations in the lumen. MRCP revealed undulant appearance and hypointensed curvilinear appearance with T2A in gallbladder. This made us think of a gallbladder aschariasis. Also, in the neck of the gallbladder there was a hypointensed stone in T1A and T2A. Because a stone was detected in both USG and MRCP, an elective laparoscopic cholecystectomy surgery was planned 10 days later. The pathologic examination confirmed the Ascaris lumbricoides. The gallbladder ascariasis is a rare clinical entity and the most reason is Ascaris lumbricoides. Numerous studies have been published about the gallbladder ascariasis and the majority of them were documented with USG as the primary modality. However Magnetic Resonance Cholangiopancreatography (MRCP) findings have been rarely reported. MRCP is a unique non-invasive method that demonstrates the gallbladder and bile duct ascariasis.

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