Torsion of the Gallbladder

Boonstra, Elizabeth A.; Prins, Ted R.; Sieders, Egbert; Leeuwen, Barbara L. van

doi:10.1007/s11605-011-1712-6

Cited by 30 publications

(26 citation statements)

References 7 publications

(9 reference statements)

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“…Liver function is normal as CBD remains unobstructed [14]. Preoperative diagnosis of gall bladder torsion is difficult since clinical features overlap with other acute gall bladder conditions [15].…”

Section: Discussionmentioning

confidence: 99%

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Volvulus of Gall Bladder-Case Report and Review of Literature

Kumar¹,

Hastir²,

Ram³

et al. 2017

Surgery

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Journal of Surgery KeywordsGall bladder volvulus; Cholecystectomy; Torsion; Cholelithiasis IntroductionGall bladder volvulus is a rare and difficult to diagnose clinically as well radiologically was first described by Wendel in 1898 [1]. More than 400 cases are reported in literature [1,2]. Volvulus of gall bladder is more common in elderly females between 7 th and 8 th decades and female to male ratio of 3:1 [3]. Causes has been attributed to anatomical variations of gall bladder mesentry and loss of visceral fat, as well mesentery with cystic duct and artery known as floating gall bladder [4][5][6][7]. When there is strong peristaltic movement or when the stomach contracts, intestines may turn and curl the gall bladder. Morbidity and mortality reported are low among cases of gall bladder torsion that have been diagnosed and treated early [8]. Delayed or missed diagnosis and treatment increase patient mortality. Symptoms vary depending on severity of disease.Although recent advance in radiology help to diagnose many diseases, abdominal computed tomography (CT) and ultrasonography (USG) remains non-specific in diagnosing volvulus of gall bladder. Coronal magnetic resonance imaging (MRI) and magnetic resonance colangio-pancreatography (MRCP) and HIDA (hepatoiminodiacetic acid) scan are helpful in making the diagnosis of volvulus of gall bladder. We report as case of gall bladder volvulus with cholelithiasis treated by laparoscopic cholecystectomy and review of gall bladder volvulus. Case PresentationA 56 year old female reported in OPD with ultrasound diagnosis of acute cholecystitis with cholelithiasis. Patient was having history of pain for last 2 days which was dull and was associated with vomiting.Clinically patient was pyrexic with no acute distress with stable vital signs. Abdomen was soft, mildly distended and tenderness in right upper quadrant and a positive Murphy's sign.After routine investigations for laparoscopic cholecystectomy next day patient was taken up for surgery. Preoperative evaluation was unremarkable. On admission into operating room, patient was monitored with ECG, noninvasive blood pressure and pulse oximetre. Anasthesia was induced by 4.0 mg of midazolam and 5 mg of Scoline, muscles were paralyzed by 50 mg of atracurium. Endotracheal intubation 7.0 mm was placed into trachea to a depth of 20 cm from front teeth. Pure oxygen was used to mechanically ventilate the lungs. Laparoscopically we found distended rotated gall bladder with a complete mesentery which was large and allows the gallbladder to hang freely i.e., recognized situation 4 of gallbladder in relation to liver as discussed in detail in discussion. Surgery was uneventful after aspiration of clear fluid from gall bladder and derotation of gall bladder, laparoscopic cholecystectomy was done AbstractGall bladder volvulus or twisting is a rare condition and occurs due to rotation of gall bladder. Preoperative diagnosis is exception and usually misdiagnosed as cholecystitis before surgery. It is potentially fatal condition unless d...

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Section: Discussionmentioning

confidence: 99%

“…Ultrasonography and computed tomography are non-specific investigations for diagnosis of volvulus [15]. Ultrasonography -A large, anteriorly floating gallbladder without gallstones and a conical appearance of the neck with discontinuity of the lumen suggest torsion.…”

Section: Discussionmentioning

confidence: 99%

Volvulus of Gall Bladder-Case Report and Review of Literature

Kumar¹,

Hastir²,

Ram³

et al. 2017

Surgery

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“…Surgical treatment, which is the only treatment option, usually serves as a diagnostic tool, as well. The choice of treatment is a cholecystectomy, which may be performed by open or laparoscopic methods [7]. Although it is very difficult to diagnose gallbladder torsion preoperatively, the possibility to encounter a technical problem during surgery is low, since the gallbladder is generally separated from the liver bed with a free pedicle in these cases, and can be mobilized easily.…”

Section: Discussionmentioning

confidence: 99%

A Rare Etiology of Acute Abdomen Syndrome: Gallbladder Torsion

Yusuf

2013

J Med Cases

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Acute abdomen syndrome is a frequently encountered clinical condition in emergency departments and includes a wide spectrum of surgical diagnoses. On the other hand, gallbladder torsion is a very rarely seen cause of the acute abdomen syndrome. A 74-year-old male patient admitted to the emergency department with abdominal pain present for two days, with gradually increasing intensity. Diffuse tenderness and guarding was present in the abdominal examination with positive Murphy sign. According to the radiologic evaluation, the patient was taken to the operation room under emergency condition with the preliminary diagnosis of gallbladder perforation. Total gallbladder necrosis due to torsion was detected in operation and cholecystectomy was performed. This case has been presented because of its rare incidence and emphasize that its preoperative diagnosis is very difficult.

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“…rare condition, being reported in only 1 of 365,520 hospital admissions. [2] The incidence of GB torsion increases with age and is more common in elderly women, with a male to female ratio of 1:3. [1,3] GB torsion occurs when it rotates along the long axis of the cystic artery and cystic duct.…”

Section: Case Reportmentioning

confidence: 99%

Twistin’ the Night Away: Gallbladder Torsion Accompanying Large Bowel Malignancy

Shikhare

Clarke

Shimpi

et al. 2015

Ulus Travma Acil Cerrahi Derg

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Gallbladder (GB) torsion is a rare surgical emergency seen in the elderly. It occurs due to the rotation of the gallbladder along the axis of the cystic artery and cystic duct. This study aimed to report a case of an acute GB torsion in an elderly female patient diagnosed by multi-detector computed tomography (MDCT). The clinical and imaging features of GB torsion, which can be used to assist in the preoperative diagnosis, were also discussed with emphasis on CT criteria.

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Torsion of the Gallbladder

Cited by 30 publications

References 7 publications

Volvulus of Gall Bladder-Case Report and Review of Literature

Volvulus of Gall Bladder-Case Report and Review of Literature

A Rare Etiology of Acute Abdomen Syndrome: Gallbladder Torsion

Twistin’ the Night Away: Gallbladder Torsion Accompanying Large Bowel Malignancy

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