Highlights
The travails in the management of complex duodenal injuries is well known among the surgical fraternity.
We here present a salvage technique of primary reinforcement with pedicled rectus abdominis muscle flap (RAMF) for a tenuous post traumatic duodenal perforation (PTDP) of the second part.
The majority of the studies in the literature are on the use RAMF for the repair of duodenal fistulas following failed primary repair of peptic perforations of first part of duodenum.
Reinforcement with RAMF is a useful rescue technique when the omentum is not available and other simpler techniques are not feasible in the primary repair setting.
Gallbladder (GB) torsion or volvulus is a rare entity affecting elderly women. Only ~500 cases have been reported in the literature. Incidence is rare seen in ~1 in 365 520.
A constant finding is the presence of the GB on a mobile mesentery. Torsion, or volvulus, of the GB occurs when it twists axially, with the subsequent obstruction of bile and/or blood flow.
We briefly describe a 75-year-old female patient with acute abdomen and ultrasound and Computed tomography of abdomen revealed a distended GB. On laparotomy, we encountered a twisted GB with gangrene and cholecystectomy was done.
GB volvulus is a rare occurrence and clinically mimic’s acute cholecystitis and should be sought with high suspicion especially when encountering a thin elderly woman. Immediate diagnosis is prime as delay may be fatal.
Even with recent advances in imaging, it is difficult to make a correct preoperative diagnosis of GB torsion.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.