The Wandering Gallbladder

Chiavarini, Robert L.; Chang, Stanley F.; Westerfield, Jerry D.

doi:10.1148/115.1.47

Cited by 21 publications

(5 citation statements)

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“…An exceedingly rare third variant consists of a normally fixed gallbladder to a mobile liver lobe free of its coronary and triangular ligaments. 9 In addition, to these mechanisms, as shown in our case, twisting of fundus along the axis of gallbladder body is another mechanism of gallbladder torsion.…”

Section: Discussionsupporting

confidence: 54%

A rare case of gallbladder torsion along the axis of body: a case report

Kwon

Kim

2015

Korean J Hepatobiliary Pancreat Surg

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Abnormal attachment of the gallbladder to the liver is the main cause for gallbladder torsion. However, the present study reports a rare case of gallbladder torsion in which a portion of fundus is rotated along the axis of body. So far, very few similar cases have been reported. An 87-year-old woman complaining right upper quadrant abdominal pain for 4 days was admitted. Her body temperature was 38.5℃ with moderate dehydration. A large tender mass was palpated on the right abdomen extending to the right iliac fossa. Computed tomography of abdomen showed a large cavity with a diameter of 15 cm containing a big stone and a small normal looking gallbladder. Ultrasonographic scan showed a twisted portion of the gallbladder torsion. During emergency laparotomy, the middle portion of the gallbladder was found to be twisted counterclockwise with huge gangrenous gallbladder distal. The proximal body of the gallbladder was spared and attached firmly to the liver. Cholecystectomy was performed and the patient was discharged 2 weeks later without postoperative complications. Histological findings of specimen were consistent with operative findings. The current study reports on a rare case of gallbladder torsion by reviewing previous studies.

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Section: Discussionsupporting

confidence: 54%

A rare case of gallbladder torsion along the axis of body: a case report

Kwon

Kim

2015

Korean J Hepatobiliary Pancreat Surg

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“…Chiavarini et al in 1974 described a case of a 22-year-old with daily episodes of abdominal pain since childhood with a transient hyperbilirubinemia. 2 Likewise, Laso et al reported an 81-year-old female with abdominal pain and a palpable mass in the epigastrium and right upper quadrant. 9 Preoperative diagnosis is difficult and rarely made.…”

Section: Discussionmentioning

confidence: 97%

“…1 Its characteristic propensity for torsion places it at risk for necrosis. 2 It is believed to be present in 4% to 5% of the population and is associated with other anatomic abnormalities such as a hypermobile liver 4 or an unusually long or absent mesentery. 1 Fewer than 10 cases of wandering gallbladder have been reported in the literature.…”

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confidence: 99%

Wandering Gallbladder: A Case Report

Kopp

Cornish

Nazir

2019

International Surgery

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Wandering gallbladder is a variation in the biliary anatomy described in the literature as being attached only by the cystic duct and its mesentery. Its propensity for torsion places it at risk for necrosis. There have been over 500 cases of gallbladder torsion reported in the literature but less than 10 reports of wandering gallbladder. To our knowledge there have been no reports of cholecystectomy for wandering gallbladder found incidentally. A 51-year-old male from Pakistan with hypertension, gastroesophageal reflux disease, high cholesterol, and renal stones presented with a chief complaint of right upper quadrant abdominal pain. Abdominal ultrasound was significant for a mildly distended gallbladder with small gallstones in the gallbladder fundus. The patient was discharged with a diagnosis of cholelithiasis and scheduled for laparoscopic cholecystectomy as an outpatient. During the procedure, upon entering the abdominal cavity, a gallbladder was not seen in the gallbladder fossa. It was attached to the cystic duct, thickened with a long mesentery and not attached to the liver. There were no signs of torsion. The patient was treated successfully and discharged home with an uncomplicated hospital course. Diagnosis can be challenging because the clinical presentation can be variable. Fewer than a dozen cases have been reported where the diagnosis was made preoperatively. Early diagnosis of gallbladder torsion with cholecystectomy is essential to avoid the deadly complications of perforation and bilious peritonitis. Understanding the pathophysiology, clinical findings, and treatment can have a broad impact across biliary surgery in preventing these complications.

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“…It is thought that there must be an underlying defect of gallbladder attachment, most commonly the gall bladder hanging from the liver on a congenital mesentery of variable length, connecting to the gallbladder and cystic duct along their length, or connecting to the cystic duct alone, leaving a freely moving gallbladder [3]. Very rarely, a hypermobile gallbladder is due to a hypermobile liver secondary to absence of coronary and triangular ligaments [4]. Another reported anatomical variation that may be an underlying defect is an aberrantly proximal origin of the cystic duct from the right hepatic duct, constituting a very narrow cystic pedicle [5].…”

Section: Discussionmentioning

confidence: 99%

A Rare Presentation of Gall Bladder Volvulus: A Case Report

et al. 2019

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Objective: Rare disease Background: Gall bladder volvulus is a rare clinical entity, with only around 500 cases reported in the literature. It is defined as the rotation of the gallbladder on its mesentery along the axis of the cystic pedicle, although cases of torsion of the gallbladder fundus itself have been reported. Case Report: A 78-year-old woman presented for severe right upper-quadrant abdominal pain that began acutely 3 days prior. Her pain was accompanied by nausea and vomiting. She also reported feeling chills. Abdominal X-ray revealed a 7-cm-diameter subhepatic opacity containing gas. Abdominal ultrasound and CT scan revealed a distended and displaced gallbladder located below the liver, in contact with the right kidney. Subsequently, open cholecystectomy was performed, and a distended, necrotic gallbladder was found twisted on its pedicle; thus, a gall bladder volvulus was diagnosed. Conclusions: In our patient, the classic patient characteristics of an elderly thin female with kyphosis were present. However, the rest of the presentation was not typical of gallbladder volvulus due to the patient's delay in seeking treatment, and was representative of the necrotic phase of gallbladder torsion, in which the patient becomes ill-appearing, with fever and chills, with significant abdominal rigidity.

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The Wandering Gallbladder

Cited by 21 publications

References 0 publications

A rare case of gallbladder torsion along the axis of body: a case report

A rare case of gallbladder torsion along the axis of body: a case report

Wandering Gallbladder: A Case Report

A Rare Presentation of Gall Bladder Volvulus: A Case Report

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