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. 2017:39:123-125.
doi: 10.1016/j.ijscr.2017.07.040. Epub 2017 Jul 25.

A late unusual complication after an open cholecystectomy: Amputation neuroma of the CBD causing obstructive jaundice

Youssef A Sleiman  1 , Ziad A Hassoun  2 , Haydar A Nasser  3 , Leila Abs  4 , Mustafa Allouch  5
Affiliations

A late unusual complication after an open cholecystectomy: Amputation neuroma of the CBD causing obstructive jaundice

Youssef A Sleiman et al. Int J Surg Case Rep. 2017.

Abstract

Introduction: Cholecystectomy is one of the most frequently done procedures in general surgery. There are few reports of amputation neuromas following this procedure. This presentation describes a case of obstructive jaundice due to amputation neuroma in a patient with a history of cholecystectomy.

Case presentation: We report about a 53 y o lady who presented with obstructive jaundice, 8 years following open cholecystectomy. Paraclinical investigations were in favor of cholangicarcinoma, however the final pathology revealed an amputation neuroma of the CBD.

Discussion: Amputation neuromas are rarely seen in the era of laparoscopic cholecystectomy. They are benign reparative lesions of the CBD following surgery or manipulation of the extra hepatic biliary tree. It is very difficult to diagnose them pre-operatively. Surgical resection is the first choice of treatment.

Conclusion: Traumatic neuromas should always be among the differential diagnosis, when assessing a CBD mass in patients with a previous history of open cholecystectomy or surgery to the gastrointestinal tract.

Keywords: Amputation neuroma about a case report; CBD; Cholecystectomy.

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Figures

Fig. 1
Fig. 1
Haphazard proliferation of nerve fibers (black arrow). The black asterisk identifies the CBD lumen.
Fig. 2
Fig. 2
(a) CT-scan showing a group of lymph nodes at the level of the proximal CBD (asterisk), (b) white arrowhead showing aerobilia.
Fig. 3
Fig. 3
MRCP showing a stricture at the level of the porta-hepatis (arrowhead).
See this image and copyright information in PMC

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