19 November, 2010

Gall Bladder : An uncommon case study

In one midnight there was pain in abdomen and it was radiating towards right back  and upper chest. When it reaches to chest  I was nervous. I was feeling uncomfortable and there was no sign of relief in about two hours.  Having no other option but to get admitted in a nearby hospital at about 03.00AM.  It was relieved only after pushing  3 injections , including one in  the belly. Then I was put into deep sleep. After  USG and MRCP they concluded  that the GB wall thickened and nothing else could be detected  on the following days. They advised for operation in due course or else similar pains may be repeated in future.

Today, we everybody know that  doctors who are attached to Private Hospitals are more commercial and they run after  to meet their financial targets fixed for each of them. My  CGHS (Central Govt. Health Scheme)  doctor  too advised me to take a second opinion from a experienced Govt. surgeon who may not be having such commercial interests.  Surgeon DR. DK Sarkar, of  Kolkata's  so called super speciality hospital (SSKM) known as  PG Hospital, who advised me to get a fresh USG, of whole abdomen, focusing on hepato biliary pancreatic system,  and LFT (Lever Function Test) tests before for giving his firm opinion. Going through the reports, he said it is a case of Polyp  and not the thick walled GB. Wall thickness is reported as normal in the report. Since it is  having polyp of more than 1cm in size, operation is must. Polyp is a growth on the inner side of the wall of GB. Generally polyp grows in the intestines but in a GB?  That to in my GB? I think it is a uncommon thing. Generally Gall stones are very common. In both cases, the GB has to be removed.


My CGHS dispensary doctor  said it is very simple surgery now a days. He  has  undergone the same surgery recently. In fact  the surgeon who operated him,  asked him to walk after the operation. Generally 48 hrs. hospitalization is required. 

We always hear about Gall bladder stones but very rarely case of Polyps we  come across. Thats what made me to share with you about  this uncommon Gallbladder ailment which is not very common as stones. Now lets see what is Polyp or GB Polyps. 


Wikipedia says in its articles :  Gallbladder polyps are growths or lesions resembling growths (polypoid lesions) in the wall of the gallbladder. True polyps are abnormal accumulations of mucous membrane tissue that would normally be shed by the body. Polypoid lesions of the gallbladder affect approximately 5% of the adult population. The causes are uncertain,  but there is a definite correlation with increasing age and the presence of gallstones (cholelithiasis). Most affected individuals do not have symptoms. The gallbladder polyps are detected during abdominal ultrasonography performed for other reasons.

Most small polyps (less than 1 cm) are not cancerous and may remain unchanged for years.However, when small polyps occur with other conditions, such as primary sclerosing cholangitis, they are less likely to be benign.Larger polyps are more likely to develop into adenocarcinomas.

Most polyps are benign and do not need to be removed. Polyps larger than 1 cm with co-occurring gallstones occurring in people over the age of 50 may have the gallbladder removed (cholecystectomy), especially if the polyps are severe or appear malignant. Laparoscopic surgery is an option for small or solitary polyps.



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