Complete torsion of gallbladder following laparoscopic cholecystectomy: A case study

Abstract

HighlightsAccurate preoperative diagnosis of gallbladder torsion is challenging because of the absence of clinical characteristics associated with it.Careful attention to symptoms during clinical presentation, including acute severe pain in the right quadrant and gallbladder deviation observed during radiological investigation, is required for accurate diagnosis of the condition.Upon confirmation of diagnosis, laparoscopic cholecystectomy would be the gold-standard treatment option rather than open cholecystectomy.

A Case of Torsion of the Gallbladder Suspected with SPECT-CT: Review and Recommendations

“…It was first reported in 1898 and Case Reports in Surgery occurs once in more than 350,000 admissions [1]. Patients are generally over 60, and 79% are females [1] and frequently have associated deformity of the spine [1,3]. Patients usually present with signs and symptoms suggesting cholecystitis [2,[6][7][8].…”

“…The etiology of the torsion always implies an anatomic abnormality that causes the gallbladder to twist [4,6,9]. Besides, a torsion-prone mesentery can develop in the elderly with loss of visceral fat, liver atrophy, and visceroptosis with the pedicle attached to the liver [3,7,8]. Constitutional anatomic variants are also implicated in the disease [3].…”

“…Besides, a torsion-prone mesentery can develop in the elderly with loss of visceral fat, liver atrophy, and visceroptosis with the pedicle attached to the liver [3,7,8]. Constitutional anatomic variants are also implicated in the disease [3]. Even though gallstones are present in 32% of the cases, they certainly do not contribute to the condition [1,6].…”

“…Definitive diagnosis is generally achieved at surgical exploration [2,8,12]. Preoperative diagnosis is done in 26% of cases [1] and more frequently in the recent reports [3,5,8,12]. The diagnosis of torsion remains difficult because of its rarity, nonspecific radiologic features [1,4,5], and similar presentation to acute cholecystitis [2,3,8].…”

“…Despite improvements in diagnostic imaging modalities, majority of the cases remain undiagnosed preoperatively [1]. Torsion of the gallbladder rapidly progresses to gangrene and is linked with a very poor prognosis, even death, if not recognized and treated in time [2][3][4][5][6][7].…”