Faculty of Medicine
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Item type:Publication, ACUTE APPENDICITIS ASSOCIATED WITH ENTEROBIUS VERMICULARIS –CASE REPORT(Македонско лекарско друштво = Macedonian medical association, 2020); ; ; Marija ToleskaEnterobius vermicularis, typically found in cecum, appendix or terminal ileum, is the cause of the most common helminthic infestation in humans. A 19-year-old female patient, with normal laboratory results, was admitted for urgent appendectomy via McBurney inci-sion. After ligation and division of the inflamed appendixfrom the cecal basis, several viable and mobile enterobiusvermiculareswere identified. A short course of alben-dazole treatment was initiated and was interrupted on the second day as a result of the strong anaphylactic reaction. Contrast enhanced CT of the abdomen iden-tified infundibulum of the gallbladder filled with iregu-larhyperdense liquid indicative for parasitic infestation. One month later, elective laparoscopic cholecystectomywas performed, and the removed gallbladder was sentfor parasitological evaluation confirming non-viable worms. Infestation with Enterobius vermicularisobstructsthe lumen of the appendix, causing contraction of the wall and results in appendicitis-like symptoms without signs of acute inflammation. In minority of cases, with pure pathological signs of inflammation a finding of Eneterobius vermicularisis incidental. There are two possible hypotheses regarding the exact mechanism of gallbladder involvement: hematogenous spread or directmigration through unhealthy intestinal tissue. It is recommended to thoroughly examine all appendiceal specimens for presence of this worm, in order to provideadequate anthelminthic therapy in case of infestation. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, True left-sided gallbladder (T-LSG) as incidental finding on laparoscopic cholecystomy - case report(Macedonian Association of Anatomists, 2021); ; ; Left - sided gallbladder, located medial ly t o the falciform ligament, between segment III and IV of the liver, has complex embryological development explained by two different concepts: one founded upon f o etal migration of the gallbladder ; and the other founded upon complex f o etal evolution of intrahepatic anatomy. 57 - year - old male was admitted for elective cholecystectomy, and , after pneumoperitoneum was established , a true left - sided gallbladder was identified. The patient wa s positioned in normal position and ports were placed on typical sites. After diligent dissection, cystic artery and duct were clipped as close as possible to gallbladder and dissected. During standard dissection in laparoscopic cholecystectomy, special at tention was dedicated to obtaining posterior critical view of safety, providing adequate exposition of structures of Calot’s triangle. Posterior critical view of safety in left - sided gallbladder exposes cardinal structures of hepatic hilus. Although, duri ng laparoscopy , difficult anatomy is met and there is high probability of bile duct injury, laparoscopic cholecystectomy is the recommended procedure of choice for left - sided gallbladder.