Lesioni polipoidi della colecisti. Presentazione di tre casi clinici di “difficile” diagnosi e revisione della letteratura

Spaziani, Erasmo and Petrozza, Vincenzo and Di Filippo, Annalisa and Picchio, M. and Ceci, Fabrizio and Miraglia, Antonella and Moretti, Valentina and Briganti, M. and Greco, E. and Pattaro, G. and De Angelis, Francesco and Salvadori, C. and Stagnitti, Franco (2010) Lesioni polipoidi della colecisti. Presentazione di tre casi clinici di “difficile” diagnosi e revisione della letteratura. Il giornale di chirurgia, 31 (10). pp. 439-442. ISSN 1971-145X

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Abstract

Introduction. Gallbladder polypoid lesions occur in 1.3%-6.9% of cases. The preoperative diagnosis between benign, malignant and potentially malignant lesions is difficult. Therefore it is not possible any. Patients and methods. The Authors describe three cases. The case 1 was a gallbladder diffuse adenomyomatosis; the ultrasound and the CT were of little help in defining preoperatively the nature and the gravity of the thickening. Case 2 was an adenomyomatosis of the fundus: the ultrasound examinations were not able to establish preoperatively lesion’s nature, site and dimensions. In the case 3, ultrasounds showed polypoid lesions and calculi concrections not found in colecistectomy. Discussion. The ultrasound is the most widely used diagnostic tool in the evaluation of gallbladder polypoid lesions; its accuracy is only 66%. CT, which has an accuracy level of 75%, must be carried out there is any possibility of malignant degeneration of the polyp. If doubts persist, a MR, 93% accuracy, is indicated. In selected cases, PET can be of further help. Conclusions. The preoperative diagnosis of the nature of gallbladder polypoid lesions is “difficult” and this justifies the lack of consensus on treatment. However, the adenoma-carcinoma sequence, widely discussed in literature, can justifies to the use of CT, MR, PET and surgical treatment after an ultrasound examination.

Item Type:	Article
Uncontrolled Keywords:	Gallbladder - Adenomiomatosi - Ecotomografia - Colecistectomia
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User:	Nadia Del Gobbo
Date Deposited:	20 Apr 2016 15:52
Last Modified:	20 Apr 2016 15:52
URI:	http://eprints.bice.rm.cnr.it/id/eprint/7193

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