Gallbladder Volvulus: An Unusual Presentation

Abstract

Patient: Female, 57-year-oldFinal Diagnosis: Gallbladder volvulusSymptoms: Abdominal and/or epigastric painMedication: —Clinical Procedure: Laparoscopic cholecystectomySpecialty: SurgeryObjective:Rare diseaseBackground:Gallbladder torsion is a rare entity of acute abdomen that can be fatal if not diagnosed and treated promptly. It presents in a multitude of ways but the most common is a presentation similar to acute cholecystitis. Diagnosis can be made clinically by abdominal ultrasound with Doppler flow, and treatment is detorsion with cholecystectomy.Case Report:A 57-year-old female presented to the emergency department with severe abdominal pain, bilious vomiting, and loose stools. An initial diagnosis of gastroenteritis was made, however, the patient did not respond to symptomatic treatment and continued having pain, nausea and vomiting. Abdominal ultrasound revealed signs of acute cholecystitis and the patient underwent an open cholecystectomy where the gallbladder was found to be black, gangrenous, and voluminous due to torsion. Detorsion and cholecystectomy were performed without any complications.Conclusions:Gallbladder torsion is a rare entity of acute abdomen that can be fatal if not diagnosed and treated promptly. Gallbladder torsion should be a part of the differential diagnosis of any patient presenting with an acute abdomen and unusual symptoms of acute cholecystitis.

Acute cholecystitis due to a gall bladder torsion

“…Clinical symptoms are not distinctive and could comprise abdominal pain, nausea, and vomiting, and a palpable mass. A triple triad has been identified to clinically dissimilate between acute cholecystitis and gallbladder volvulus: the first is patient features, The second is based on clinical signs of intense onset pain, right upper quadrant pain, and vomiting, The third is of clinical characteristics on physical examination: a palpable mass in the right upper quadrant [1] laboratory data of gallbladder torsion often indicate elevated inflammatory response however there is a normal liver function, our case demonstrated that only the inflammation response, and not biliary and liver function, increased.…”

“…Gallbladder torsion is a rare phenomenon of an acute abdomen. It was first described in 1898 by Wendel in a 25-year-old pregnant woman [1] .…”

“…The cause of torsion is usually due to underlying anatomical variations acute cholecystitis is the most common presentation of gall bladder volvulus [ [1] , [2] , [3] , [4] , [5] , [6] , [7] ]. The preoperative diagnosis presents a dilemma.…”

Acute Cholecystitis due to a gall bladder torsion: A case report

“…In Type II, the cystic duct alone is attached to the liver [3] Clinical symptoms are not distinctive and could comprise abdominal pain, nausea, and vomiting, and a palpable mass. A triple triad has been identified to clinically dissimilate between acute cholecystitis and gallbladder volvulus: the first is patient features, The second is based on clinical signs of intense onset pain, right upper quadrant pain, and vomiting, The third is of clinical characteristics on physical examination: a palpable mass in the right upper quadrant [1]. laboratory data of gallbladder torsion often indicate elevated inflammatory response.…”

“…Gallbladder torsion is a rare phenomenon of an acute abdomen. It was first described in 1898 by Wendel in a 25-year-old pregnant woman [1]. It happens when adhesion between the gallbladder and liver is lost.…”