Incidental Discovery of a Phrygian Cap During Whipple's Procedure: A Case Report

TL;DR

A 48-year-old woman with pancreatic cancer and obstructive jaundice had a rare anatomical variation, a Phrygian cap of the gallbladder, discovered during surgery.

Contribution

This case report highlights the incidental discovery of a Phrygian cap during Whipple's procedure and its surgical implications.

Findings

A Phrygian cap of the gallbladder was incidentally found during a Whipple's procedure for pancreatic head cancer.

The case emphasizes the need for adaptability and precision in managing anatomical variations during complex surgeries.

Comparisons with similar cases show varied approaches to incidental findings based on clinical indications.

Abstract

Obstructive jaundice, characterised by yellow discolouration of the skin and mucous membranes due to reduced bile flow, often necessitates surgical intervention for resolution. This article provides a comprehensive literature review to contextualise the management of obstructive jaundice, focusing on common treatment modalities such as common bile duct (CBD) stenting and Whipple's procedure for pancreatic head cancer. Additionally, the incidental finding of a Phrygian cap of the gallbladder during surgical intervention for pancreatic head cancer is described in detail. A case presentation of a 48-year-old female with obstructive jaundice and pancreatic head cancer is outlined, detailing the diagnostic process, treatment decisions, and surgical interventions. The patient underwent CBD stenting followed by Whipple's procedure to address the pancreatic head cancer, during which the incidental discovery of a Phrygian cap of the gallbladder was noted. The discussion of the incidental finding highlights the complexity it adds to surgical interventions and emphasises the importance of adaptability and precision in managing anatomical variations. A comparison with similar cases underscores varying approaches to managing incidental findings, ranging from conservative observation to surgical excision based on clinical indications. This case underscores the significance of thorough diagnostic evaluation and surgical intervention in managing incidental findings such as the Phrygian cap, ensuring appropriate patient management and favourable clinical outcomes in complex surgical scenarios.

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