Gallbladder torsion: case report and review of 245 cases reported in the Japanese literature

Abstract

We report here a case of torsion of the gallbladder in a 73-year-old woman. The patient was admitted to our hospital with right hypochondralgia. Ultrasonography and computed tomography demonstrated a distended gallbladder, with a multilayered wall, which contained no stones. Since the symptoms did not respond to antibiotics, laparotomy was performed. The gallbladder was found to be twisted around its pedicle and to be gangrenous. Cholecystectomy was performed, and the patient had an uneventful postoperative course. We also reviewed 245 cases reported in the Japanese literature. The clinical features of gallbladder torsion, which include low frequency of fever and jaundice, poor response to antibiotic therapy, and acute onset of abdominal pain, may be helpful in the differential diagnosis from acute cholecystitis. Moreover, a highly suggestive sign of gallbladder torsion observed by ultrasonography or computed tomography is a markedly enlarged "floating" gallbladder with a continuous hypoechoic line indicating edematous change in the wall.

Volvulus of gall bladder: case report

“…8 Presence of gall stones has been described in 24% of the reported cases and their role is unclear. 7,12,13 As condition is rare and occurs in less than 0.1% patients who undergo urgent cholecystectomies for presumed acute cholecystitis. 12 Correct preoperative diagnosis of gall bladder volvulus is very rare with less than dozen cases have been diagnosed accurately with pre-operative imaging.…”

“…7,12,13 As condition is rare and occurs in less than 0.1% patients who undergo urgent cholecystectomies for presumed acute cholecystitis. 12 Correct preoperative diagnosis of gall bladder volvulus is very rare with less than dozen cases have been diagnosed accurately with pre-operative imaging. 5 Despite technological advances in radiology, definitive diagnosis is generally achieved intra-operatively.…”

“…5 Despite technological advances in radiology, definitive diagnosis is generally achieved intra-operatively. 12 Patient usually presents with acute abdominal pain in upper quadrant with or without vomiting. There may be presence of tender mobile mass indicating a floating gall bladder.…”

Volvulus of Gall Bladder-Case Report and Review of Literature

“…The susceptibility of rotation may be attributed to the elderly's fat less and tissue atrophy suspending gall bladder freely [8]. Presence of gall stones has been described in 24% of the reported cases [7,12,13] and their role is unclear. As condition is rare and occurs in less than 0.1% patients who undergo urgent cholecystectomies for presumed acute cholecystitis [12].…”

“…Despite technological advances in radiology, definitive diagnosis is generally achieved intra-operatively [12].…”