Strangulated gallbladder caused by a tip of the omentum attached to the abdominal wall: a case report

Abstract

Strangulation of the gallbladder associated with the omentum is extremely rare and, to our knowledge, only two cases have been previously reported. The patient was a 91-year-old female who presented to our emergency room with a chief complaint of upper abdominal pain. Computed tomography imaging revealed a gourd-shaped gallbladder with biphasic appearance divided clearly at the body. In the fundus side, the wall of the gallbladder was oedematous and thickened, while the neck side was intact. On the second day after onset, a laparoscopic cholecystectomy was performed. A tip of the omentum encircling the gallbladder was adhered to the abdominal wall and was strangling the gallbladder. By cutting the omentum at the attachment site, the strangulation was released. Laparoscopic cholecystectomy was performed, and the patient was discharged with an uneventful course. We experienced an extremely rare case of strangulated gallbladder caused by a tip of the omentum attached to the abdominal wall.

Gallbladder strangulation caused by a fibrotic band due to chlamydia infection: A case report

“…Strangulated cholecystitis is an extremely rare phenomenon, and only four cases have been described in the English literature (Table 1). [2][3][4][5] Gallbladder torsion and strangulated gallbladder have similar clinical symptoms and imaging findings. Both conditions cause blood flow impairment in the gallbladder.…”

Omental band causing gallbladder strangulation: a rare cause of cholecystitis and gallbladder perforation

“…The three aforementioned cases of gallbladder strangulation exclusively affected females and were all successfully treated with an LC . None of the patients were preoperatively diagnosed with gallbladder strangulation and the diagnosis was ultimately made intraoperatively.…”

“…Gallbladder strangulation is a rare phenomenon; in fact, only three cases have been described in literature . In two of these cases, gallbladder strangulation was caused by the lesser omentum and the third case was of a tip of omentum that was attached to the abdominal wall strangulating a free‐floating gallbladder . Free‐floating gallbladders are an anatomical variant and there are two types described in literature .…”

“…Unlike acute cholecystitis which may be treated initially with antibiotics, gallbladder strangulation must be treated with an emergency cholecystectomy to avoid adverse outcomes. In gallbladder strangulation, the blood supply and biliary drainage are both compromised . Subsequently, there is development of ischaemic cholecystitis, or alternatively a pattern of relapsing and remitting fundic cholecystitis.…”

“…). A CT may help establish a preoperative diagnosis as the gallbladder may demonstrate a biphasic appearance – where one section of the gallbladder may be oedematous and thickened due to venous congestion or inflammation and the other section is intact . This biphasic appearance could theoretically be also found on ultrasound in the hands of an experienced sonographer.…”