Morphological Spectrum of Gall Bladder Diseases at A Tertiary Care Hospital of Karachi

  • Asma Shabbir JSMU
  • Zareen Irshad
  • Saba Javed
  • Fakiha Nadeem
  • Nazish Jaffar
  • Syed Mehmood Hasan
Keywords: Cholelithiasis, cholecystitis, adenocarcinoma

Abstract

Objectives: To determine morphological spectrum of gall bladder diseases at a tertiary care centre of Karachi and to correlate with age and gender

Methodology: Data was collected from histopathological records between June 2017 to June 2019. Relevant data including registration number, age, gender of the patients and diagnosis were recorded. Data was entered and analyzed using SPSS version 21. P-value < 0.05 was considered as significant.

Results: In our study, patients 26-35 years of age were predominantly found to be susceptible to gall bladder diseases and male to female ratio was 1:3.7. Out of the total 150 cases, 75 were identified as chronic cholecystitis with cholelithiasis whereas 32 cases of chronic cholecystitis were without stones or any other associated pathology. Out of 150 cases, 40 were seen in combination with different pathologies. Our series also included three cases of adenocarcinoma and all of these were diagnosed in females. Significant association of diagnosis was seen with gender and type of stones (p-value = 0.03) (p-value = 0.01) respectively.

Conclusion: In our study, chronic cholecystitis with cholelithiasis was the most common finding which was most predominantly seen in females. Younger age group was mainly affected in both genders. Mixed type of gall stones were the most common stones found in our series. 

References

Sangwan, M.K., V. Sangwan, M.K. Garg, D. Singla, P. Malik, and A. Duhan, Incidental carcinoma of gallbladder in north India: is routine histopathology of all cholecystectomy specimens justified? Int J Surgery. 2016; 2(4):465-470.

Maurer K.J, MM Ihrig, AB Rogers, Vivian Ng, Bouchard G, MR Leonard, et al. Identification of cholelithogenic enterohepatic helicobacter species and their role in murine cholesterol gallstone formation. Gastroenterology. 2005; 128(4):1023-1033.

Gangwar P, Rathore LKPS, Gupta R, and Singh L. Heptoprotective Action of katuki. Eur J Biomed Pharm Sci.2018;5(1):892-895.

Singh PK, PK Arya, HS Khetarpal, K Goyal, HS Jolly, T Din, et al., Epidemiology of gallstone disease in a tertiary care hospital-- a changing trend in current perspective. J Evol Med & Dent Sci. 2017;6(75):5332-5337.

Noble F and Johnson C. Gallstones. Medicine Elsevier, 2015; 43(11):689-693.

Nayak AK, A Anand, and D Sahoo, Role of Pathological Organisms in Gallstone disease. J Pharm Biomed Sci. 2016; 6(3): 155-157.

Cariati A, Gallstone classification in western countries. Indian J Surg. 2015;77(2):376-380.

Jaleel F, K Rashid, N Bakhtiar and M Jawaid. Risk factors of gallstones. The Professional Med J. 2017; 24(11):1675-1679.

Rawla P, T Sunkara, KC Thandra and A Barsouk, Epidemiology of gallbladder cancer.Exp Clin Hep. 2019;5(2):93.

Goetze TO, Gallbladder carcinoma: prognostic factors and therapeutic options. World J Gastroenterol. 2015; 21(43):12211-7.

Venneman NG, W Renooij, JF Rehfeld, GP vanBerge‐Henegouwen, PM Go, IA Broeders, et al., Small gallstones, preserved gallbladder motility, and fast crystallization are associated with pancreatitis. Hepatology. 2005;41(4):738-746.

Al-Assi K, R Hatia, V Rallapalli, Y Abugabal, A Abdelhakeem, R Abdel-Wahab, et al. Gallbladder disease in the absence of cirrhosis is a significant risk factor for hepatocellular carcinoma. J Hepatology. 2019.

Paulin F, JF Mercado, ME Fernández, FM Caro, ML Alberti, and LA Fassola, Correlation between Lung and Joint Involvement in Patients with Rheumatoid Arthritis and Interstitial Lung Disease: A Cross-Sectional Study. Rev Invest Clín.2018;70(2): 76-81.

Vahed LK and L Khedmat, Frequency of symptoms associated with gallstone disease: a hospital-based cross sectional study. Eur J Trans Myol.2018; 28(2).

Figueiredo JC, C Haiman, J Porcel, J Buxbaum, D Stram, N Tambe, et al., Sex and ethnic/racial-specific risk factors for gallbladder disease. BMC gastroenterol.2017;17(1):153.

Wang S, Y Wang, J Xu, and Y Chen. Is the oral contraceptive or hormone replacement therapy a risk factor for cholelithiasis: A systematic review and meta-analysis. Medicine(Baltimore). 2017; 96(14):6556.

Kshirsagar AY, Kabra MV, Reddy M, Panicker S, and Phadke A. A study to correlate low serum iron levels with gallstones. J Evol Med & Dent Sci. 2015; 4(104):16912-16915.

Gomati A, S Elafi, H Rafe, E Abimbola, A Willido and R Sahitha, A study on the Risk factors for Gallbladder diseases in El-khoms Teaching Hospital, Libya. IOSR-JDMS. 2014: 13(2):1-4.

Kim HS, Cho SK, Kim CS, and Park JS. Big data and analysis of risk factors for gallbladder disease in the young generation of Korea. PloS one, 2019;14(2).

Mansoor S, Effan F, Ibnerasa S, Butt S and Rathore S. Morphological Spectrum of Gallbladder Disease: a retrospective study in a private medical college in Lahore. Pak J Med Sci.2017; 11(4): 1505-1508.

Masood I, Rasheed H and Raheem A, Cohort study: occurrence rate of occult gallbladder carcinoma and its curative strategies. Pak J Surg, 2016. 32(4):245-249.

Sharma,RK, Bisht N, and Neki N, Histopathological examination of various lesions of gall bladder in routine 488 cholecystectomy specimens-A hospital based study. Int J Curr Res Med Sci. 2017; 3(8):112-118.

Turkcu G, Alabalık U, Keles AN, Ibiloglu I, Hamidi A, and Ulger BV. Institutional experience in the histopathological characteristics and frequency of gallbladder lesions. Int J Clin Exp Pathol. 2016;9(1):176-180.

Nagi GS and Arora R. Incidence of various types of gallstones in patients of cholelithiasis in north Ind J Evol Med & Dent Sci.2015;4(97):16213-16215.

Channa NA, Khand FD, and Bhanger MI. Analysis of human gallstones by FTIR. Malaysian J Ana Sci.2008;12(3):552-560.

Tassaduqe K, Ali M, Salam A, Latif M, Af-roze N, Masood S. et al., Studies on the Chemical Composition and Presentation of Gallstones in Relation to Sex and Age among Human Population of Multan, Pakistan. J Biol Sci. 2004; 4(4):470-473.

You Y, Bui K, Bui MM, Malafa M, and Coppola D. Histopathological and immunophenotypical features of intestinal-type adenocarcinoma of the gallbladder and its precursors. Cancer Control. 2014;21(3):247-250.

Rashmi H, Shivamurthy Y, Suresh K and Chatura K. Histopathological study to establish the association of gallstones with cholecystitis and carcinoma of gallbladder. MedPulse Int J Pathol.2018;5(3):56-59.

Published
2020-07-11