Gallbladder Disease in an Elderly Patient

Khandelwal, Cathleen

doi:10.1001/jamasurg.2013.309

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…Therefore, the presence of ultrasound signs suggestive of cholecystitis in the absence of cholelithiasis can suggest the diagnosis of gallbladder volvulus as an alternative [3,4,9]. CT findings are mainly the beak sign, as a result of the transition of the distended gallbladder to a fulcrum point in the gallbladder hilum, and the whirl sign, which represents the rotation of the pedicle [3,14,18]. Other findings are a massively distended gallbladder, pericholecystic fluid, and a gallbladder outside its anatomical fossa.…”

Section: Discussionmentioning

confidence: 99%

Gallbladder Volvulus in an Elderly Patient: A Case Report and Review of Literature

Matías-García,

Sainz-Azara,

Mendoza-Moreno

et al. 2023

Cureus

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Gallbladder volvulus is an uncommon cause of acute cholecystitis that results from the rotation of the gallbladder about its mesentery along the axis of the cystic pedicle. We present the case of an 87-year-old woman with acute abdominal pain in the right upper quadrant that began two days prior with no additional symptoms. The physical examination showed a large abdominal eventration on the right side and tenderness. A CT scan showed a distended gallbladder outside its liver bed and with a twist on its cystic pedicle, suggesting a gallbladder volvulus. Abdominal ultrasonography complementary revealed the gallbladder outside its vesicular fossa with incipient changes of acute cholecystitis but without evidence of gallstones. With the diagnosis of acute abdomen secondary to gallbladder volvulus, an emergency cholecystectomy was performed. The exact etiology of the gallbladder volvulus is unknown, although anatomical variants that predispose to its appearance have been described. The clinical presentation is similar to acute cholecystitis, so preoperative diagnosis can be challenging for both surgeons and radiologists and is often misdiagnosed. This is one of the few cases diagnosed with preoperative imaging techniques. Once diagnosed, the appropriate treatment is emergency cholecystectomy. Early diagnosis and surgical treatment are important before it progresses to necrosis, perforation, biliary peritonitis, and hemodynamic instability. Gallbladder volvulus is an uncommon condition. A high index of suspicion is required because the preoperative diagnosis is unusual. Once the diagnosis is established, the treatment is fundamentally surgical.

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Section: Discussionmentioning

confidence: 99%

Gallbladder Volvulus in an Elderly Patient: A Case Report and Review of Literature

Matías-García,

Sainz-Azara,

Mendoza-Moreno

et al. 2023

Cureus

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“…Traditionally, GT is known as associated with old-aged females (11,18). GT has been reported as preponderance in females, 3-5 times more than males and the mean and median age were 64 and 77, respectively (6,11,19).…”

Section: Discussionmentioning

confidence: 99%

“…LC is recommended as the first-line surgical treatment of acute inflammatory GB disease (2). In addition, the GT should be managed promptly by the surgical method after diagnosis (18,24). In recent reports, torsion was managed successfully by laparoscopy (5,7,25) and some surgeons have tried the single incision laparoscopic method (26).…”

Section: Discussionmentioning

confidence: 99%

A comparative analysis of gallbladder torsion and acute gallbladder disease without torsion: a single-center retrospective case series study

2021

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Background: Acute gallbladder disease (AGD) is frequent in the emergency department (ED), and usually requires surgical intervention. Gallbladder torsion (GT) is a rare entity among patients with AGD. There are sparse reviews of GT's clinical characteristics, and there is no comparative study between them in the same patient cohort. Therefore, we report the case series of GT, and compare the statistical differences between GT and non-GT with AGD.Methods: We collected retrospective data from patients who visited ED with AGD and underwent emergency cholecystectomy between January 2005 and December 2020. We combined consecutive case series of GT and compared them with non-GT gallbladder disease.Results: Six GT cases were diagnosed over the study duration. Five were female (83%) and the average age was 77.8 years. All patients presented with abdominal pain, and the median duration of pain was two days.Only two cases were suspected for GT pre-operatively (33%). One patient underwent laparotomy, and the others underwent laparoscopic cholecystectomy with a mean operation time of 59 min. The torsion direction was of the same proportion in both directions; five (83%) were rotated completely. The mean length of hospital stay was 9.3 d and outcomes were favorable in most GT cases. In the comparative study between GT and non-GT, age was higher in the GT group (P=0.048), and duration or severity of pain showed no statistical difference (P=0.528; P=0.637, respectively). Body temperature was higher in the non-GT group without statistical significance (P=0.074). Gallstones were present in 68.8% of the non-GT group, which is significantly higher than that of the GT group (P=0.036).Conclusions: Six exceptional GT cases were managed successfully. The overall characteristics of each GT case demonstrated similar with previous reviews. Our comparative analysis showed that age, pulse rate, serum creatinine level, and gallstone presence showed statistical differences. Contrary to the traditional knowledge of GT, some distinct features like sex, duration or severity of pain, and fever showed no significant differences within AGD in our research.

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Gallbladder Disease in an Elderly Patient

Cited by 2 publications

References 6 publications

Gallbladder Volvulus in an Elderly Patient: A Case Report and Review of Literature

Gallbladder Volvulus in an Elderly Patient: A Case Report and Review of Literature

A comparative analysis of gallbladder torsion and acute gallbladder disease without torsion: a single-center retrospective case series study

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