Description
Clinical History
A 60-year-old man head a history of four episodes of severe gripping abdominal pain during the previous year, each lasting two hours and associated with meals. He presented with a similar attack associated with vomiting and fever. This last attack did not resolve spontaneously, and he underwent cholecystectomy.
Pathology
A thick-walled gallbladder has been opened to display a thickened hemorrhagic mucosa and many irregular faceted calculi. A large calculus is impacted in the neck of the gallbladder. The serosal surface of the gall bladder is congested and has lost its normal sheen. This is an example of cholecystitis complicating cholelithiasis (gallstones).
Further Information
Acute cholecystitis is characterized by the clinical syndrome of right upper quadrant pain, fever and jaundice. Gallstones account for the vast majority of acute cholecystitis, with only 5 - 10% of cases being due to other pathology. Chronic cholecystitis may occur, resulting from recurrent attacks and causing fibrosis and thickening of the gallbladder wall. 6-11% of patients with symptomatic gallstones will go on to develop acute cholecystitis. Serum biochemistry will demonstrate leukocytosis with or without obstructive liver function tests. Ultrasound will demonstrate gallstones in the gallbladder, along with wall thickening and a sonographic Murphy's sign (tenderness from the pressure of the ultrasound probe). Other imaging modalities include nuclear medicine cholescintigraphy scans, MRCP (magnetic cholangiopancreatography) and CT. Endoscopic Retrograde Cholangiopancreatography (ERCP) will provide diagnostic information regarding biliary obstruction and may also be therapeutic. Causative organisms (if present) will be from the gut flora, commonly E coli, Enterococcus, Klebsiella and Enterobacter. Complications include gangrenous cholecystitis, perforation, cholecystoenteric fistula or gallstone ileus. Definitive treatment is surgical cholecystectomy.
Advantages
- Anatomically accurate and identical to real specimen
- No ethical issues - not real human body parts
- Reasonably priced
- Available within a short lead time
- Reproducible, several identical prints can be used as a classroom set
- Can be produced in different sizes to cater for the needs of the teacher
Human Cadavers
- Access to cadavers can be problematic. Many countries cannot access cadavers for cultural and religious reasons
- Cadavers cost a lot money
- High cost for establishing your own plastination suite
- Wet specimens cannot be used in uncertified labs
- Dissection of cadavers is a lot of staff time and that is a cost
- Storage of cadaver material needs special refrigeration etc. which has coast
- If you want another specimen you have to start all over again
Plastinates
- Costs
- Ethical issues
- Timeframe for plastination process
- Many countries do not allow their importation
- One of a kind
Superior 3D print results compared with conventional methods
- Vibrant color offering with 10 million colors
- UV-curable inkjet printing
- High quality 3D printing that can create products that are delicate, extremely precise and incredibly realistic
Clear Support Material
- To avoid breakage of fragile, thin, and delicate arteries, veins or vessels, a clear support material is printed on such spots. This makes the models robust and can be handled by students easily.
