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Acute gallbladder torsion: an unexpected intraoperative finding.

Janakan G, Ayantunde AA, Hoque H - World J Emerg Surg (2008)

Bottom Line: It is known to occur when there is rotation of the gallbladder along the axis of the cystic duct and vascular pedicle.Except for isolated cases reported in childhood, this disease is more frequently encountered in the elderly with 85% of the cases reported between the ages of 60 and 80 years.There is a female preponderance with a female to male ratio of 3:1.

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Affiliation: Department of Surgery, Queen Mary's Hospital, Sidcup, Kent, DA14 6LT, UK. biodunayantunde@yahoo.co.uk.

ABSTRACT
Gallbladder torsion is an uncommon clinical entity and a difficult condition to diagnose preoperatively. Since its first description in 1898 by Wendel there have been over 500 documented cases in the literature. It is known to occur when there is rotation of the gallbladder along the axis of the cystic duct and vascular pedicle. Except for isolated cases reported in childhood, this disease is more frequently encountered in the elderly with 85% of the cases reported between the ages of 60 and 80 years. There is a female preponderance with a female to male ratio of 3:1. Gallbladder torsion typically presents as an acute abdomen requiring emergency surgery but preoperative diagnosis of gallbladder torsion is difficult and most cases are found as a surprise at surgery.We report a case of acute gallbladder torsion in an elderly lady and review the clinical aspect of the disease.

No MeSH data available.


Related in: MedlinePlus

CT scan of the abdomen and pelvis in sagittal section.
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Figure 2: CT scan of the abdomen and pelvis in sagittal section.

Mentions: She was resuscitated with IV fluids and an emergency computerized tomography (CT) scan of the abdomen and pelvis was performed. This was reported as showing an oval cystic lesion in the central abdomen, with an AP diameter of 6 cm and a transverse diameter of 9 cm. This structure was unilocular with no connection to the bowel or mesentery but compressing the transverse colon (Figures 1 &2). There were dilated small bowel loops in the pelvis. The liver, spleen, pancreas and both kidneys were normal. The decision to continue resuscitation and to further evaluate the patients for the nature of this mass was taken. However, by the next day, her pain had increased in severity and the central abdominal mass was more tender. The decision was then taken to proceed to an emergency laparotomy.


Acute gallbladder torsion: an unexpected intraoperative finding.

Janakan G, Ayantunde AA, Hoque H - World J Emerg Surg (2008)

CT scan of the abdomen and pelvis in sagittal section.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2266718&req=5

Figure 2: CT scan of the abdomen and pelvis in sagittal section.
Mentions: She was resuscitated with IV fluids and an emergency computerized tomography (CT) scan of the abdomen and pelvis was performed. This was reported as showing an oval cystic lesion in the central abdomen, with an AP diameter of 6 cm and a transverse diameter of 9 cm. This structure was unilocular with no connection to the bowel or mesentery but compressing the transverse colon (Figures 1 &2). There were dilated small bowel loops in the pelvis. The liver, spleen, pancreas and both kidneys were normal. The decision to continue resuscitation and to further evaluate the patients for the nature of this mass was taken. However, by the next day, her pain had increased in severity and the central abdominal mass was more tender. The decision was then taken to proceed to an emergency laparotomy.

Bottom Line: It is known to occur when there is rotation of the gallbladder along the axis of the cystic duct and vascular pedicle.Except for isolated cases reported in childhood, this disease is more frequently encountered in the elderly with 85% of the cases reported between the ages of 60 and 80 years.There is a female preponderance with a female to male ratio of 3:1.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Queen Mary's Hospital, Sidcup, Kent, DA14 6LT, UK. biodunayantunde@yahoo.co.uk.

ABSTRACT
Gallbladder torsion is an uncommon clinical entity and a difficult condition to diagnose preoperatively. Since its first description in 1898 by Wendel there have been over 500 documented cases in the literature. It is known to occur when there is rotation of the gallbladder along the axis of the cystic duct and vascular pedicle. Except for isolated cases reported in childhood, this disease is more frequently encountered in the elderly with 85% of the cases reported between the ages of 60 and 80 years. There is a female preponderance with a female to male ratio of 3:1. Gallbladder torsion typically presents as an acute abdomen requiring emergency surgery but preoperative diagnosis of gallbladder torsion is difficult and most cases are found as a surprise at surgery.We report a case of acute gallbladder torsion in an elderly lady and review the clinical aspect of the disease.

No MeSH data available.


Related in: MedlinePlus