Torsion of the gallbladder: A rare cause of acute cholecystitis

Lemonick, David M.; Garvin, Robert P.; Semins, Howard

doi:10.1016/j.jemermed.2005.07.011

Cited by 18 publications

(26 citation statements)

References 18 publications

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“…In these anatomic variations, there is a free-floating gallbladder. Another possibility is that relaxation and atrophy of a previously normal mesentery in the elderly cause visceroptosis 4,5. For the final torsion, a provocative moment is needed.…”

Section: Overview Of the Literaturementioning

confidence: 99%

Torsion of the Gallbladder

Boonstra

Prins

Sieders

et al. 2012

Journal of Gastrointestinal Surgery

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IntroductionA 77-year-old woman was seen with progressive abdominal pain.CasesA CT scan was made and showed a large gallbladder extending into the right lower abdomen. Ultrasound was performed but demonstrated no gallstones. Laparoscopy showed a tordated, necrotic gallbladder that was attached to the liver only by the cystic artery and cystic duct. Cholecystectomy was performed.ConclusionsTorsion of the gallbladder is a rare but clinically important condition in which the diagnosis seldom is made preoperatively. In radiological and clinical signs of cholecystitis without gallstones, this condition should be considered.

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Section: Overview Of the Literaturementioning

confidence: 99%

Torsion of the Gallbladder

Boonstra

Prins

Sieders

et al. 2012

Journal of Gastrointestinal Surgery

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“…Gall bladder torsion is a rare entity affecting approximately 1 in 365 520 patients, and representing 0.1% of acute cholecystitis presentations 1. There have been approximately 500 cases reported in the literature since it was first described by Wendell in 1898 2–4. The vast majority of these cases are involving the geriatric population.…”

Section: Discussionmentioning

confidence: 99%

Gall bladder torsion: a disease of the elderly

2019

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We describe the case of a gall bladder torsion in an elderly female patient, which was discovered during laparoscopic exploration for presumed acute cholecystitis. The rising incidence of this relatively uncommon process can be attributed to increasing life expectancy. Gall bladder torsion typically manifests in septuagenarians and octogenarians of the female gender, as seen in the presented case. It is thought that local mesenteric redundancy predisposes to the development of mechanical organoaxial torsion along the gall bladder’s longitudinal axis involving the cystic duct and artery. Clinicians must have a high index of suspicion for gall bladder torsion, as a mimicker of acute cholecystitis, in the described patient demographic. Preoperative diagnosis is challenging with the vast majority of reported cases being diagnosed intraoperatively, and only five cases preoperatively. Prompt surgical intervention results in an overall mortality rate of approximately 5%, while a delay in diagnosis can lead to catastrophic patient outcomes.

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“…Clinical presentation may be different either the twist is under 180° (incomplete), with progressive abdominal pain, or over 180° (complete), with acute onset of abdominal pain, nausea and vomiting. Torsion of the gallbladder neck leads to mural ischemia consecutive to cystic duct obstruction and/or cystic artery strangulation (Lemonick et al 2006 ; Alevizos et al 2012 ).…”

Section: Discussionmentioning

confidence: 99%