A Case of Acute Cholecystitis Caused by Heterotopic Pancreatic Tissue in the Gallbladder

Nobuhiko Okamoto, Kazuo Yamafuji, Junichi Matsui, Atsunori Asami, Kaoru Takeshima, Noritaka Hayashi and Hideo Baba

Department of Surgery, Saitama Municipal Hospital

A 78-year-old woman admitted for upper abdominal pain and showing increased inflammation despite transaminases, alkaline phosphatase, and total bilirubin within normal limits was found in. Ultrasonography to have marked swelling and wall thickening of the gallbladder diagnosed as acute cholecystitis necessitating percutaneous transhepatic gallbladder drainage (PTGBD). Direct cholangiography through the PTGBD tube showed stenosis in the gallbladder neck but computed tomography and endoscopic ultrasonography showed no abnormality. Bile cytology through the PTGBD tube was negative. Laparoscopic cholecystectomy yielded macroscopic findings of stenosis in the gallbladder junction and cystic duct without any mucosal lesion. Pathohistological examination of the excised specimen showed heterotopic Heinrich II type pancreatic tissue.

Key words
heterotopic pancreas tissue, acute cholecystitis, laparoscopic cholecystectomy

Reprint requests
Nobuhiko Okamoto Department of Surgery, Saitama Municipal Hospital
2460 Mimuro, Midori-ku, Saitama, 336-8522 JAPAN

Accepted
December 17, 2008

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