Background: One of the most common gastrointestinal surgeries is cholecystectomy. Gallstones are the major causes of cholecystectomy and induce various histopathologic changes. Gallbladder carcinoma is rare with poor prognosis. Metaplasic changes in gallbladder epithelium are considered precancerous lesions. Objectives: This study aimed at revealing the spectrum of histopathological patterns of gallbladder diseases in cholecystectomy specimens. Methods: A total of 1004 gallbladder H & E stained slides of cholecystectomy specimens over one year were studied. Histopathological evaluation was done by 6 pathologists in terms of variables. Results: In our study, the male: female ratio was 1: 2. 1. The age of patients varied from 17 to 96 years with a mean age of 49. 1 years. The mean age of patients with gallstones was 47. 52 years and was more common in women. Cholesterol, pigmented, and mixed stones were reported in 58. 36%, 39. 03%, and 2. 6% of gallstones, respectively. The mostcommonhistological morphology was chronic calculous cholecystitis (61. 18%). The incidence of metaplasia and invasive carcinoma was 19. 55% and 0. 2%, respectively. Conclusions: In this study, histopathological analysis of gallbladder diseases in the cholecystectomy specimens revealed that chronic calculous cholecystitis was the most common histologic finding. Gallstones were found more commonly in women and cholesterol stone was the predominant type. Pyloric metaplasia was the most frequent type of metaplasia. The rate of invasive carcinoma is compatible with those reported in the literature. Routine histopathological analysis of the cholecystectomy specimens will help to detect incidental carcinoma and precursors of malignancy.

Background: Gallstone disease, traditionally associated with older, overweight females, is increasingly being observed in younger individuals. This shift necessitates a closer examination of the unique characteristics and risk factors associated with gallstone development in this demographic. While conventional risk factors such as gender, age, and genetic predispositions continue to play a role, emerging trends suggest that modifiable factors, including dietary habits, lifestyle choices, and medical conditions, are also influential. Methods: In this observational study conducted at Al Wahda Teaching Hospital in Derna, Libya, between January 2021 and January 2022, we retrospectively collected data from 182 patients diagnosed with gallbladder disease. The study focused on recording demographic information and assessing modifiable risk factors, including dietary habits, reproductive history, smoking, and associated chronic illnesses. Results: The majority of patients were female (92.3%), with the most commonly affected age group being 26 - 30 years. The average weight of the population was also notably high. Assessment of modifiable risk factors revealed a high prevalence of a high-fat diet (75.8%) and a sedentary lifestyle (73.6%), while surprisingly, 69.2% maintained a high-fiber diet. A range of chronic illnesses contributed to a small proportion of cases, including hemolytic anemia (13.2%), diabetes mellitus (5.5%), and liver disease (4.4%). The predominance of laparoscopic cholecystectomy (54.9%) indicates a shift in treatment approach. Complications were absent in the majority of cases (81.3%), suggesting a generally favorable outcome in gallstone disease management within this cohort. Conclusions: The evolving nature of gallstone disease in younger populations calls for a reassessment of understanding and management strategies. The observed trends highlight the need for further research to better understand the changing landscape of gallstone disease and to develop targeted preventive measures for this demographic.

Traumatic injuries to the gallbladder are rare. This is attributed to its anatomical location and protection by the liver. Direct penetrating trauma is the commonest mechanism of injury. Here is the report of a 27-year-old otherwise healthy male who sustained gallbladder perforation following the penetration of abdominal injury in a domestic fight. A high index of suspicion is necessary for early diagnosis. He safely underwent an open cholecystectomy and his postoperative recovery was uneventful.

Neuroendocrine tumors (NET) arise from neuroendocrine cells and are an exceedingly rare malignancy in the gallbladder. In this case report, a 52-year-old woman with complaints of episodic abdominal pain for two months prior was admitted to our hospital. She had no other signs and symptoms and her laboratory tests were within normal limits. Ultrasonography showed a broad-necked mass (26×12 mm) in the gallbladder for which she underwent laparoscopic cholecystectomy. The final pathological diagnosis was a high grade neuroendocrine carcinoma of the gallbladder with involvement of the lymph nodes and omentum. The patient received the chemotherapy regimens of gemcitabine plus cisplatin, followed by docetaxel plus sunitinib for her metastatic liver lesions. She also underwent radiofrequency ablation. Serial CT-scans revealed metastatic liver lesions that had decreased in size, with no significant improvement. The patient refused additional treatment and at 46 months, she was doing well with no complaints of any pain, disease recurrence, or metastatic progression.

Volvulus of the gallbladder or gallbladder torsion (GT), is a condition in which an organ twists along its long axis leading to the vascular source compromise. The GT was first diagnosed in 1898 as a rare cause of idiopathic cholecystitis. Some 500 cases have been reported ever since, and they account for 0. 1% in acute cholecystitis cases. An 85-year-old male patient presented with epigastric abdominal pain that was referred to as the upper abdominal quadrant (UAQ). The pain did not radiate elsewhere but was constant and severe. Moreover, it did not change with eating; nonetheless, the patient had anorexia, nausea, and biliary vomiting that occur two times. Fever and chills, weight loss, and icterus were not observed. According to the ultrasound report, flat cholecystitiswas diagnosed, and the patient underwent cholecystectomy. During the operation, GT was confirmed. Diagnosis of GT in elderly patients without symptoms of acute abdomen and cholecystitis should be considered in differential diagnosis to prevent complications and mortality.

Fundal gallbladder abnormalities result from broad spectrum of pathologic that most of them have no pathological significance and normally causes no symptoms. Conversely, early incidental detection of malignant lesions is important because symptomatic lesions are often incurable. So use proper imaging to differentiate between them is important. Although ultrasound has been the choice screen method of gallbladder diseases, making an accurate diagnosis may be impossible. Now day, multiphase MRI and CT scan have become the imaging technique that are widely used to detect and to characterized gallbladder abnormalities. In crosssectional imaging analysis of finding included evaluation of thickness, contour, intralesional cystic areas, enhancement pattern, presence of stone, etc. may help to differentiated fundal gallbladder abnormalities. The porpoise of this educational exhibit is to describe gross anatomy and pathologic appearance of each abnormalities and demonstrate features of them in ultrasound, CT scan and MRI with emphasis on the specific characteristics and will review the role of imaging in the differentiation of these. Abnormalities included: Phrygian cap: Mostcommoncongenital anatomic variant of gallbladder that is asymptomatic and characterized by folding of the fundus on the body. Although ultrasound isn’ t always conclusive but usually clearly identify in CT scan and MRI. Fundal septation: It is rare and usually asymptomatic and result of incomplete cavitation of gallbladder bud. In ultrasound demonstrated as an echogenic band crossing the lumen and in CT scan and MRI usually clearly identify. Localized chronic cholecystitis: Most common form of clinically symptomatic gallbladder diseases that there is evidence of chronic inflammation in pathology and may have a history of biliary colic. Ultrasound demonstrate gallbladder wall thickening and usually with cholelithiasis, without any pericholecystic inflammation. In CT scan, focal fundal thickening with flat contour and adjacent gallbladder thickening is seen. The most common finding in MRI is cholelithiasis and wall thickening without any pericholecystic inflammation. Adenomyomatosis: Has been reported in 2-8% of cholecystectomy specimens and have a predilection for the middle and elderly aged womenand is usually asymptomatic or paucisymptomatic. It is widely accepted to be a degenerative disease and is characterized by Rokitansky-Aschoff sinuses that are responsible for the imaging finding. Specific ultrasound signs are anechoic intramural diverticulumwith or without comet tail artifacts. Optimal CT scan evaluation of gallbladder require IV contrast and Rosary sign is highly suggestive. MRI finding are focal mass, mural thickening and pearl necklace sign. Fundal gallbladder cancer: uncommon but most common primary biliary carcinoma and predominantly affects elderly women that often present when extend to liver or adjacent structures. Over 90% are adenocarcinoma. Cross-sectional appearance is that of a mass replacing the gallbladder (40%-65%), focal wall thickening (20%-30%) or an intraluminal polypoid mass (15%-25%). Ultrasound isn’ t usually useful if there isn’ t any invasion but there are several features that may be useful, polipoid lesions greater than 1 cm, focal wall thickening > 1 cm, heterogeneous mass or asymmetric thickening. CT scan with contrast is extremely helpful (dual phase) and finding suggesting cancer are hypo or iso attenuating heterogeneous mass, adjacent invasion, pronounced wall thickening(> 1 cm), thickness with mural irregularity or marked asymmetry. Caner in MRI is typically T1 hypo intense and T2 hyper compare with liver parenchyma, typically shows early irregular contrast enhancement which persists into delayed images. Stones are common. Conclusions: All of gallbladder fundal abnormalities should be kept in the mind during imaging and knowledge of the characteristic imaging finding of each abnormalities are essential in order to manage patients.

Background: Nutrition‑, related factors have been of great interest as one of risk factors of biliary stones. This study evaluated the association of dietary patterns with biliary stone among Iranians. Methods: This is a hospital‑, based case‑, control study, which was conducted in a general hospital in Tehran, Iran. A total of 110 patients with gallstone or common bile duct (CBD) stone confirmed by Ultrasonography within the last 6 months before collecting data were recruited. Controls were age‑, matched patients admitted to the other wards of the same hospital for a broad spectrum of disorders including traumas and orthopedic conditions, or elective surgeries, or throat/ear/nose disease and had no gallbladder disorders, participated in this study. We used a valid and reliable food frequency questionnaire to assess dietary intakes of participants. Dietary patterns were determined by factor analysis. Results: By design, age was similar in both groups (57. 66 ±,16. 39 years vs. 56. 00 ±,10. 64 years in cases and controls, respectively). Two dietary patterns were extracted,“, Unhealthy”,(high consumption of artificial juice, processed meats, refined grains, sweets and desserts, pickles, snacks, and red meats), and “, Healthy”,(high consumption of vegetable oils, vegetables, fruits, fish, legumes, and nuts, as well as low consumption of hydrogenated fats and salt). Participants in the highest tertile of “, Healthy”,dietary pattern were significantly less likely to have the gallstones disease (OR: 0. 33, 95% CI = 0. 120. 89) compared to the reference group (low tertile of “, Healthy”,dietary pattern) (P = 0. 02). Conclusions: High consumption of vegetable oils, vegetables, fruits, fish, legumes, and nuts, as well as low consumption of hydrogenated fats and salt in context of healthy dietary pattern are inversely associated with risk of gallstones.

Gallbladder duplication is a rare congenital anomaly, which is not accompanied by specific symptoms,however, it is usually associated with cholelithiasis. A 52-year-old man is described, who was referred to the hospital complaining of pain. Ultrasonography indicated the presence of Boyden’, s Type II gallbladder duplication with stones in the left gallbladder and cholecystitis in both gallbladders. The patient underwent cholecystectomy. In the pathology report, chronic inflammation of the gallbladder was reported. Furthermore, the presence of a second gallbladder was confirmed.