A gallbladder torsion presenting as acute cholecystitis in an elderly woman: A case report

Boer, J. 't Lam; Boerma, Djamila; Reilingh, T. S. de Vries

doi:10.1186/1752-1947-5-588

Cited by 29 publications

(50 citation statements)

References 13 publications

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“…Doppler ultrasound6 and MR cholangiopancreatography5 have been used successfully as preoperative imaging modalities, although diagnosis is frequently made at surgery. Presentation is similar to that of acute cholecystitis but the clinical course and management of the disease differs considerably, notably due to the ensuing necrosis and risk of perforation 7. It is this risk that necessitates early operative removal to prevent peritonitis and its sequelae 2 8.…”

Section: Discussionmentioning

confidence: 99%

Torted gallbladder causing massive distension and gross necrosis; a rare surgical emergency

Ball

Dalmia²,

Rajamanickam³

et al. 2013

BMJ Case Reports

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Gallbladder torsion is rare and is more frequently seen in elderly women. Published case reports comment that diagnosis of this entity can be made preoperatively through imaging with some advocating removal laparoscopically. This case reports an elderly woman who underwent emergency laparotomy for a massively distended gallbladder with suspected cholecystitis. At laparotomy the gallbladder was found to be torted over 360° round its pedicle of the cystic duct and artery. The torsion was so pronounced that the gallbladder was massively distended and grossly necrotic with a high risk of perforation. As the pedicle was long the gallbladder was easily separated form the liver and removed in its entirety. This case presented significant diagnostic and management difficulties. By observing the clinical features in the triad of triads for gallbladder volvulus prompt diagnosis, investigation and treatment can be started for this rare emergency presentation.

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Section: Discussionmentioning

confidence: 99%

Torted gallbladder causing massive distension and gross necrosis; a rare surgical emergency

Ball

Dalmia²,

Rajamanickam³

et al. 2013

BMJ Case Reports

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show abstract

“…Gallbladder blood flow can be examined in detail by Doppler USG, and a decreased or absent pericholecystic vascularity suggests torsion [6]. In the present case, the gallbladder was hydropic with an increased wall thickness and hypoechogenic submucosal layer.…”

Section: Discussionmentioning

confidence: 74%

A Rare Etiology of Acute Abdomen Syndrome: Gallbladder Torsion

Yusuf

2013

J Med Cases

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Acute abdomen syndrome is a frequently encountered clinical condition in emergency departments and includes a wide spectrum of surgical diagnoses. On the other hand, gallbladder torsion is a very rarely seen cause of the acute abdomen syndrome. A 74-year-old male patient admitted to the emergency department with abdominal pain present for two days, with gradually increasing intensity. Diffuse tenderness and guarding was present in the abdominal examination with positive Murphy sign. According to the radiologic evaluation, the patient was taken to the operation room under emergency condition with the preliminary diagnosis of gallbladder perforation. Total gallbladder necrosis due to torsion was detected in operation and cholecystectomy was performed. This case has been presented because of its rare incidence and emphasize that its preoperative diagnosis is very difficult.

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“…The cystic artery is usually thrombosed due to the torsion. The absence of mesenteric attachment makes the procedure reasonably straightforward unless there are adhesions 4. These steps were followed during surgery of our patient.…”

Section: Discussionmentioning

confidence: 99%

Gallbladder volvulus with segmental right liver lobe hypoplasia/atrophy: a preoperative diagnostic dilemma

et al. 2018

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Gallbladder volvulus (GBV) due to rotation of the gall bladder (GB) around its own mesentery is a rare surgical emergency and often identified intraoperatively. Typically, cholecystitis is the initial clinical diagnosis, but a high index of suspicion on imaging can alert the physician for the possibility of GBV requiring urgent surgical intervention. We describe a case of a young female patient with hypoplasia/atrophy of the posterior segment of the right liver lobe and a GB with no hepatic attachments but only mesenteric pedicle. She presented with first episode of sudden-onset, severe right subcostal pain. The ultrasonogram and magnetic resonance cholangiopancreatogram findings were suggestive of GBV. She underwent laparoscopic exploration that confirmed GBV of a free-floating GB with a thrombosed cystic artery. The GB was detorted, and cholecystectomy was performed. She had an uneventful postoperative course and was discharged with no complications. Histopathological examination showed intramural haematoma of the GB with wall necrosis.

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A gallbladder torsion presenting as acute cholecystitis in an elderly woman: A case report

Cited by 29 publications

References 13 publications

Torted gallbladder causing massive distension and gross necrosis; a rare surgical emergency

Torted gallbladder causing massive distension and gross necrosis; a rare surgical emergency

A Rare Etiology of Acute Abdomen Syndrome: Gallbladder Torsion

Gallbladder volvulus with segmental right liver lobe hypoplasia/atrophy: a preoperative diagnostic dilemma

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