Torsion of the Gallbladder in a Nine-Year-Old Boy

Chilton, Chris; Mann, Charles V.

doi:10.1177/014107688007300213

Cited by 15 publications

(5 citation statements)

References 8 publications

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“…However, if the mesentery is particularly long or attaches to the gallbladder only at the cystic duct, the gallbladder will lie suspended freely from a point within the peritoneal cavity and there will be a predisposition to twisting ( Figure 3 ). 5 This predisposition is not just a congenital one; atrophy of the liver and loss of elastic tissue with age and loss of supporting structures such as fat may also free the gallbladder, allowing it to twist on a pedicle. 2 , 6 This configuration likely accounts for the aetiology in this case.…”

Section: Discussionmentioning

confidence: 99%

Gallbladder volvulus: it’s a small whirl

Layton¹,

Rudralingam²,

Lamb

2016

BJR|case reports

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An 85-year-old female with an extensive past medical history attended our accident and emergency department with vague abdominal pain and distension. Clinical examination and initial blood tests demonstrated features of sepsis and she was commenced on broad spectrum antibiotics. Following admission, a contrast-enhanced CT scan of the abdomen and pelvis was performed, which showed an unusual configuration of the gallbladder. There was significant luminal distension of the gallbladder, which was found to lie in an unusual horizontal position anterior to the liver edge. This was a new finding compared with a recent CT pulmonary angiogram that demonstrated a normal gallbladder anatomy. In addition, there was abrupt angulation of the gallbladder neck, demonstrating a “beak” sign as well as indrawing of the vascular pedicle forming a mini “swirl” sign. The constellation of gallbladder distension, abnormal lie, “beak” and mini “swirl” sign together is a strong indicator of gallbladder torsion. Coexistent right lower lobe pneumonia was noted. The patient was too frail for surgical intervention and succumbed to underlying sepsis. Post-mortem examination demonstrated a gangrenous gallbladder secondary to volvulus. We present a rare case of gallbladder volvulus and highlight CT findings to help the radiologist make a pre-operative diagnosis.

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Section: Discussionmentioning

confidence: 99%

Gallbladder volvulus: it’s a small whirl

Layton¹,

Rudralingam²,

Lamb

2016

BJR|case reports

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“…10 Intense peristalsis of stomach, duodenum and colon as well as kyphoscoliosis and atherosclerosis of cystic artery have also been associated. 4,5,7,11 The susceptibility of rotation may be attributed to the elderly's fat less and tissue atrophy suspending gall bladder freely.…”

Section: Discussionmentioning

confidence: 99%

Volvulus of gall bladder: case report

Kumar¹,

Hastir²,

Walia³

et al. 2017

Int Surg J

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Gall bladder volvulus or twisting is a rare condition and occurs due to rotation of gall bladder. Preoperative diagnosis is exception and usually misdiagnosed as cholecystitis before surgery. It is potentially fatal condition unless diagnosed and treated early leading to gangrene and biliary peritonitis. It has been reported in only about 500 cases in the literature ranging in age given 2-100 years old. We report a rare case of middle aged female 56 years old with volvulus of gall bladder having concomitant cholelithiasis treated with laparoscopic cholecystectomy.

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“…Only situations 4 and 5 can predispose to torsion of gall bladder [10]. Intense peristalsis of stomach, duodenum and colon as well as kyphoscoliosis and atherosclerosis of cystic artery have also been associated [4,5,7,11].…”

Section: Discussionmentioning

confidence: 99%

Volvulus of Gall Bladder-Case Report and Review of Literature

Kumar¹,

Hastir²,

Ram³

et al. 2017

Surgery

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Journal of Surgery KeywordsGall bladder volvulus; Cholecystectomy; Torsion; Cholelithiasis IntroductionGall bladder volvulus is a rare and difficult to diagnose clinically as well radiologically was first described by Wendel in 1898 [1]. More than 400 cases are reported in literature [1,2]. Volvulus of gall bladder is more common in elderly females between 7 th and 8 th decades and female to male ratio of 3:1 [3]. Causes has been attributed to anatomical variations of gall bladder mesentry and loss of visceral fat, as well mesentery with cystic duct and artery known as floating gall bladder [4][5][6][7]. When there is strong peristaltic movement or when the stomach contracts, intestines may turn and curl the gall bladder. Morbidity and mortality reported are low among cases of gall bladder torsion that have been diagnosed and treated early [8]. Delayed or missed diagnosis and treatment increase patient mortality. Symptoms vary depending on severity of disease.Although recent advance in radiology help to diagnose many diseases, abdominal computed tomography (CT) and ultrasonography (USG) remains non-specific in diagnosing volvulus of gall bladder. Coronal magnetic resonance imaging (MRI) and magnetic resonance colangio-pancreatography (MRCP) and HIDA (hepatoiminodiacetic acid) scan are helpful in making the diagnosis of volvulus of gall bladder. We report as case of gall bladder volvulus with cholelithiasis treated by laparoscopic cholecystectomy and review of gall bladder volvulus. Case PresentationA 56 year old female reported in OPD with ultrasound diagnosis of acute cholecystitis with cholelithiasis. Patient was having history of pain for last 2 days which was dull and was associated with vomiting.Clinically patient was pyrexic with no acute distress with stable vital signs. Abdomen was soft, mildly distended and tenderness in right upper quadrant and a positive Murphy's sign.After routine investigations for laparoscopic cholecystectomy next day patient was taken up for surgery. Preoperative evaluation was unremarkable. On admission into operating room, patient was monitored with ECG, noninvasive blood pressure and pulse oximetre. Anasthesia was induced by 4.0 mg of midazolam and 5 mg of Scoline, muscles were paralyzed by 50 mg of atracurium. Endotracheal intubation 7.0 mm was placed into trachea to a depth of 20 cm from front teeth. Pure oxygen was used to mechanically ventilate the lungs. Laparoscopically we found distended rotated gall bladder with a complete mesentery which was large and allows the gallbladder to hang freely i.e., recognized situation 4 of gallbladder in relation to liver as discussed in detail in discussion. Surgery was uneventful after aspiration of clear fluid from gall bladder and derotation of gall bladder, laparoscopic cholecystectomy was done AbstractGall bladder volvulus or twisting is a rare condition and occurs due to rotation of gall bladder. Preoperative diagnosis is exception and usually misdiagnosed as cholecystitis before surgery. It is potentially fatal condition unless d...

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Torsion of the Gallbladder in a Nine-Year-Old Boy

Cited by 15 publications

References 8 publications

Gallbladder volvulus: it’s a small whirl

Gallbladder volvulus: it’s a small whirl

Volvulus of gall bladder: case report

Volvulus of Gall Bladder-Case Report and Review of Literature

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