Torsion of the gallbladder: a systematic review

Reilly, DJ; Kalogeropoulos, George; Thiruchelvam, Dhan

doi:10.1111/j.1477-2574.2012.00513.x

Cited by 91 publications

(245 citation statements)

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“…Review of the current literature shows that gallbladder volvulus commonly presents as an acute cholecystitis, although isolated cases of gallbladder torsion mimicking acute appendicitis have also been reported [6,8]. Since no single clinical, serologic, or radiographic finding is pathognomonic, this condition is often misdiagnosed as acute acalculous cholecystitis, making a correct preoperative diagnosis challenging [4,5,9]. According to a review by Reilly et al [4], a preoperative diagnosis of gallbladder torsion was made in 32 of 125 (26%) patients reported within the last 20 years and death as an outcome was reported in seven of the 113 patients presenting after 1991 representing a mortality rate of 6%.…”

Section: Discussionmentioning

confidence: 99%

“…Since no single clinical, serologic, or radiographic finding is pathognomonic, this condition is often misdiagnosed as acute acalculous cholecystitis, making a correct preoperative diagnosis challenging [4,5,9]. According to a review by Reilly et al [4], a preoperative diagnosis of gallbladder torsion was made in 32 of 125 (26%) patients reported within the last 20 years and death as an outcome was reported in seven of the 113 patients presenting after 1991 representing a mortality rate of 6%. The main complications associated with delayed diagnosis and treatment includes necrosis, gangrene and subsequent perforation of the gallbladder resulting in contamination of the abdominal cavity with bilious material.…”

Section: Discussionmentioning

confidence: 99%

“…It can be either incomplete (rotation less than 180 degrees, usually gradual onset) or complete (rotation more than 180 degrees, usually acute onset) [3]. Both clockwise (occurs as a result of gastric and duodenal peristalsis) and anticlockwise rotations (secondary to colonic peristalsis) have been described [4].…”

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Gallbladder torsion: A case study

Yasser¹,

Zukiwskyj²,

Lucky³

et al. 2016

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. Torsion of the gallbladder is a rare condition and an important differential of an acute surgical abdomen. While early surgical intervention reduces the risk of disease progression to life-threatening complications, and thus avoids high morbidity and mortality, it is difficult to make a preoperative diagnosis of gallbladder torsion. Case Report: In this report, we describe a case of acute gallbladder torsion in an elderly male whose clinical presentation mimicked acute acalculous cholecystitis with local inflammatory reaction resulting from gangrenous gallbladder. The 81-year-old male was treated with emergency exploratory laparotomy. Except for developing an ileus requiring longer term recovery his post-operative period was otherwise uneventful and no further complications were evident in his follow-up clinic assessment. Conclusion:There is a wide range of differential diagnoses for patients presenting with acute surgical abdomen. Rare but life-threatening condition such as gallbladder torsion still remains a diagnostic challenge. Early diagnosis is the paramount in managing patients with gallbladder torsion as immediate surgical intervention is required. Keeping high index of clinical suspicion for patients presenting to emergency department with acute abdomen, especially in elderly population followed by diagnostic imaging can aid prompt diagnosis and thus facilitate early treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Gallbladder torsion: A case study

Yasser¹,

Zukiwskyj²,

Lucky³

et al. 2016

IJCRI

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“…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].…”

Section: Introductionmentioning

confidence: 99%

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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“…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 mesentery and loss of visceral fat, as well mesentery with cystic duct and artery known as floating gall bladder.…”

Section: Introductionmentioning

confidence: 99%

Volvulus of gall bladder: case report

Kumar¹,

Hastir²,

Walia³

et al. 2017

Int Surg J

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Gall 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 diagnosed and treated early leading to gangrene and biliary peritonitis. It has been reported in only about 500 cases in the literature ranging in age given 2-100 years old. We report a rare case of middle aged female 56 years old with volvulus of gall bladder having concomitant cholelithiasis treated with laparoscopic cholecystectomy.

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Torsion of the gallbladder: a systematic review

Abstract: Improved imaging techniques within the last 20 years have enabled the preoperative diagnosis of one quarter of patients with gallbladder torsion. With prompt surgical intervention, the condition has an excellent prognosis.

Cited by 91 publications

References 12 publications

Gallbladder torsion: A case study

Gallbladder torsion: A case study

Volvulus of Gall Bladder-Case Report and Review of Literature

Volvulus of gall bladder: case report

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