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Enrique Domínguez-Muñoz, Emma Martínez Moneo, Federico Bolado Concejo, Fernando Alberca de las Parras, Fernando Carballo ÿlvarez, F. Javier Elola Somoza" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "pgl" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical practice guidelines</span>" "titulo" => "Pancreas units within gastroenterology departments. Organizational and operational standards for a patient-centered service" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Las unidades de páncreas en los servicios de aparato digestivo. Estándares de organización y funcionamiento para un servicio centrado en el paciente" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 962 "Ancho" => 1667 "Tamanyo" => 65732 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hospital discharges for pancreatic cancer and acute pancreatitis, 2016–2021.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Enrique Domínguez-Muñoz, Emma Martínez Moneo, Federico Bolado Concejo, Fernando Alberca de las Parras, Fernando Carballo Álvarez, F. Javier Elola Somoza" "autores" => array:6 [ 0 => array:2 [ "nombre" => "J. Enrique" "apellidos" => "Domínguez-Muñoz" ] 1 => array:2 [ "nombre" => "Emma" "apellidos" => "Martínez Moneo" ] 2 => array:2 [ "nombre" => "Federico" "apellidos" => "Bolado Concejo" ] 3 => array:2 [ "nombre" => "Fernando" "apellidos" => "Alberca de las Parras" ] 4 => array:2 [ "nombre" => "Fernando" "apellidos" => "Carballo Álvarez" ] 5 => array:2 [ "nombre" => "F. Javier" "apellidos" => "Elola Somoza" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382424001470?idApp=UINPBA00004N" "url" => "/24443824/unassign/S2444382424001470/v2_202406080413/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image of the month</span>" "titulo" => "Septated gallbladder" "tieneTextoCompleto" => true "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Cándido Alcázar, Juan Jesús Rubio, Víctor Cristóbal, José M. Ramia" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Cándido" "apellidos" => "Alcázar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Juan Jesús" "apellidos" => "Rubio" "email" => array:1 [ 0 => "juanjesus1010@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Víctor" "apellidos" => "Cristóbal" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "José M." "apellidos" => "Ramia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Cirugía Hepatobiliopancreática y Trasplante Hepático, Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario Dr. Balmis, Alicante, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital General Universitario Dr. Balmis, Alicante, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Vesícula biliar septada" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 381 "Ancho" => 1000 "Tamanyo" => 40489 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) MRI: cystic lesion attached to the GB with lithiasis inside. B) MRI-cholangiogram. CL: biliary cystic lesion; GB: gallbladder; PC: pancreatic cystic lesions compatible with intraductal papillary mucinous neoplasm.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 68-year-old male came in to Accident and Emergency with heartburn, low-grade fever and abdominal pain. He reported frequent episodes of upper right quadrant pain. Lab tests showed no significant abnormalities. A CT scan was performed, showing a multiloculated cystic lesion of the pancreas in the uncinate process, a 5-mm main pancreatic duct, cholelithiasis and a biliary cystic lesion. CEA and CA19-9 were requested, which were normal. MRI-cholangiogram showed a gallbladder (GB) with multiple stones, a 3.6-cm cystic lesion adjacent to the GB, and pancreatic lesions compatible with intraductal papillary mucinous neoplasm (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B). With the diagnosis of symptomatic cholelithiasis and GB cystic lesion, laparoscopy revealed a bi-lobed GB with a cystic duct, and a laparoscopic cholecystectomy was performed. Histological study reported: GB of 10  × 4 × 3.5 cm, with a fibrous septum at the neck creating two compartments (septate GB) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A and B).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Septate GB with a single septum or multiple septa is a very rare anomaly.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a> Its prevalence is much higher in females. The most accepted theory in terms of aetiology is incomplete cavitation of the GB. Two thirds of patients have symptoms, with upper right quadrant pain being the most common<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a>. Preoperative diagnosis is complex. Differential diagnosis should be made with desquamated GB mucosa, cholesterolosis, hydatid cyst and congenital/acquired intramural diverticulosis. A cholecystectomy should be performed on adult patients with biliary symptoms<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a>.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 381 "Ancho" => 1000 "Tamanyo" => 40489 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) MRI: cystic lesion attached to the GB with lithiasis inside. B) MRI-cholangiogram. CL: biliary cystic lesion; GB: gallbladder; PC: pancreatic cystic lesions compatible with intraductal papillary mucinous neoplasm.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 714 "Ancho" => 1000 "Tamanyo" => 140564 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Surgical specimen. A) Gallbladder, showing it to be bi-lobed (arrow). B) Gallbladder after staining for pathology study, where the intravesicular septum can be seen.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Septate gallbladder: a rare cause of biliary colic" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B. Finlay" 1 => "E.L. Neo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ans.17556" "Revista" => array:6 [ "tituloSerie" => "ANZ J Surg." "fecha" => "2022" "volumen" => "92" "paginaInicial" => "3091" "paginaFinal" => "3092" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35170840" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anomalous gallbladder septum-A case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Bamback" 1 => "K.C. Baumgardner" 2 => "M. Bartanuszova" 3 => "H.L. Nation" 4 => "A.P. Occhialini" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijscr.2021.106082" "Revista" => array:3 [ "tituloSerie" => "Int J Surg Case Rep." "fecha" => "2021" "volumen" => "84" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gallbladder duplication: evaluation, treatment, and classification" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.W. Causey" 1 => "S. Miller" 2 => "C.A. Fernelius" 3 => "J.R. Burgess" 4 => "T.A. Brown" 5 => "C. Newton" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpedsurg.2009.12.015" "Revista" => array:7 [ "tituloSerie" => "J Pediatr Surg." "fecha" => "2010" "volumen" => "45" "numero" => "2" "paginaInicial" => "443" "paginaFinal" => "446" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20152372" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/24443824/unassign/S2444382424002219/v1_202409270422/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/24443824/unassign/S2444382424002219/v1_202409270422/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382424002219?idApp=UINPBA00004N" ]
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