Phrygian Cap Gallbladder and Recurrent Pancreatitis in a Woman

  • Vitorino Modesto dos Santos Mail Department of Internal Medicine, Armed Forces Hospital and Catholic University of Brasília, Brasília-DF, Brazil
  • Samuel Abner Department of Internal Medicine of Armed Forces Hospital, Brasília-DF, Brazil.
  • Marcelo Martins Oliveira Gastroenterology Division of Armed Forces Hospital, Brasília-DF, Brazil.
  • Viviane Vieira Passini Soares Department of Internal Medicine of Armed Forces Hospital, Brasília-DF, Brazil.
  • Uadson Silva Barreto Department of Internal Medicine of Armed Forces Hospital, Brasília-DF, Brazil.
  • Lister Arruda Modesto dos Santos Department of General Surgery, State Workers Hospital, São Paulo-SP, Brazil.
Keywords:
Hydropic gallbladder, Pancreatitis, Phrygian cap anomaly, Saint’s triad

Abstract

A 65-year-old woman with hypothyroidism and arterial hypertension was admitted with epigastric pain and hyperemesis. Five months before, she had the diagnosis of non-lithiasic acute pancreatitis without complications, and the hypothesized etiology was alcohol abuse. The current manifestations were initially related to an active gastric ulcer evidenced by the endoscopic study. Laboratory data were consistent with acute pancreatitis, and ultrasonography showed images of pancreatitis, in addition to the incidental detection of the hydropic gallbladder with a Phrygian cap. These diagnoses were confirmed by the imaging study of computed tomography with contrast. Clinical significance of Phrygian cap anomaly is herein emphasized because of diagnostic challenges, in addition to possible etiopathogenic role in cholecystitis, gallstones, and pancreatitis. The eventual association of the gallbladder anomaly with the Saint’s triad is also commented. This scarcely reported triad includes hiatus hernia, diverticulosis, and lithiasic cholecystopathy.

 

Author Biographies

Vitorino Modesto dos Santos, Department of Internal Medicine, Armed Forces Hospital and Catholic University of Brasília, Brasília-DF, Brazil

Adjunct-Professor of the Internal Medicine Department

Marcelo Martins Oliveira, Gastroenterology Division of Armed Forces Hospital, Brasília-DF, Brazil.

Medical Doctor of Gastroenterology Division of Armed Forces Hospital

Viviane Vieira Passini Soares, Department of Internal Medicine of Armed Forces Hospital, Brasília-DF, Brazil.

Medical Doctor of Internal Medicine of Armed Forces Hospital

Uadson Silva Barreto, Department of Internal Medicine of Armed Forces Hospital, Brasília-DF, Brazil.

Medical Doctor of Internal Medicine of Armed Forces Hospital

Lister Arruda Modesto dos Santos, Department of General Surgery, State Workers Hospital, São Paulo-SP, Brazil.

Preceptor of General Surgery, State Workers Hospital,São Paulo-SP,Brazil

References

A 65-year-old woman with hypothyroidism and arterial hypertension was admitted with epigastric pain and hyperemesis. Five months before she had the diagnosis of non-lithiasic acute pancreatitis without complications, and the hypothesized etiology was alcohol abuse. The current manifestations were initially related to an active gastric ulcer evidenced by endoscopic study. Laboratory data were consistent with acute pancreatitis, and ultrasonography showed images of pancreatitis, in addition to the incidental detection of hydropic gallbladder with a Phrygian cap. These diagnoses were confirmed by the imaging study of computed tomography with contrast. Clinical significance of Phrygian cap anomaly is herein emphasized because of diagnostic challenges, in addition to possible etiopathogenic role in cholecystitis, gallstones and pancreatitis. The eventual association of the gallbladder anomaly with the Saint’s triad is also commented. This scarcely reported triad includes hiatus hernia, diverticulosis, and lithiasic cholecystopathy.

Published
2019-01-16
How to Cite
1.
Modesto dos Santos V, Abner S, Oliveira M, Soares V, Barreto U, Santos L. Phrygian Cap Gallbladder and Recurrent Pancreatitis in a Woman. Acta Med Iran. 56(11):729-731.
Section
Case Report(s)