A Surgical “Chimera”: The Gallbladder Volvulus in the Spigelian Hernia Sac

Abstract

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Incarcerated Spigelian hernia containing the gangrenous gallbladder

“…Most cases reported are internal hernias through the Winslow foramen, but GH in other abdominal hernias (e.g. ventral or parastomal) has also been described 2 . Multiple factors predispose to GH in elderly patients: the loss of visceral fat and elastic tissue, liver shrinkage and lengthening of the gallbladder's mesentery.…”

“…Multiple factors predispose to GH in elderly patients: the loss of visceral fat and elastic tissue, liver shrinkage and lengthening of the gallbladder's mesentery. The acute cholecystitis of a herniated gallbladder can be triggered by an obstructive mechanism (stones), or by strangulation or torsion 2 . The most frequent clinical scenario of GH is right lower quadrant pain, worsening general condition and non‐reducible hernia.…”

“…The most frequent clinical scenario of GH is right lower quadrant pain, worsening general condition and non‐reducible hernia. CT is essential for the diagnosis of gallbladder in the hernia sac, and it also provides additional information on the abdominal wall defect 2 . If GH is suspected, the lump should not be reduced, in order to avoid the risk of gallbladder perforation.…”

“…CT is essential for the diagnosis of gallbladder in the hernia sac, and it also provides additional information on the abdominal wall defect. 2 If GH is suspected, the lump should not be reduced, in order to avoid the risk of gallbladder perforation. Cholecystectomy is recommended even in patients without cholecystitis.…”

Gallbladder torsion

“…Majoritatea autorilor descriu că litiaza vezicii biliare este detectată în 1/3 de cazuri, însă cu siguranță nu contribuie la dezvoltare TVB [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]22]. De asemenea sunt descrise cazuri de hernierea vezicii biliare torsionate în hernia parastomală [30], foramenul lui Winslow [31] și Spigel [32].…”