Curious and rare
It was the pain that gave Benancia H., from the province of Andahuaylas, no peace. The mother of six children pinned her hopes on the Diospi Suyana hospital and traveled five hours through the mountains to Curahuasi. On the upper right side, her stomach was hurting and had been for a whole year. The physical examination and an ultrasound scan quickly shed light on the situation. Not only medical professionals already guess what the correct diagnosis is. Correct: gallstones.
Surgeon Lukas Steffen got to work and removed the gallbladder in a laparoscopic procedure. A routine case, one might think. But not at all! In the case of Benancia, there were three special features.
1. in her case, a stone at the outlet of the gallbladder was pressing on the common bile duct, causing bile stasis. This phenomenon, described as Mirizzi syndrome, causes jaundice (increase in bilirubin in the blood)
2. the entire internal gallbladder wall was calcified and resembled an egg. This is called a porcelain gall bladder.
3. there was a gallbladder empyema, i.e. the gallbladder was filled with pus.
The patient has long since returned home and is rejoicing with her loved ones over the good outcome of the operation. And Dr. Steffen knows he won’t be seeing this trifecta of rarities again anytime soon.
