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Acute gallbladder torsion: an unexpected intraoperative finding.

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

Bottom Line: Since its first description in 1898 by Wendel there have been over 500 documented cases in the literature.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

Intraoperative finding of gangrenous gallbladder.
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Figure 3: Intraoperative finding of gangrenous gallbladder.

Mentions: Emergency laparotomy through a midline incision was performed and findings at operation included a large, gangrenous gallbladder with a 360 degree clockwise torsion on its long pedicle. The gallbladder was distinctly suspended free from the liver edge and lying over the greater omentum and transverse colon with some haemorrhagic peritoneal fluid reaction. The torted pedicle was undone and cholecystectomy was performed. The opened gallbladder had complete hemorrhagic infarct with wall thickness of about 1 cm across (Figures 3 &4). The pathological examination of the specimen revealed an 8 cm enlarged gallbladder, 4.5 cm in diameter, with a 1 cm thick oedematous wall with mucosal congestion and the histological findings were consistent with acute gangrenous cholecystitis with extensive necrosis of the wall. Post-operative recovery was uneventful and she was discharged home 8th day post surgery. The delay in discharge was due to social reason.


Acute gallbladder torsion: an unexpected intraoperative finding.

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

Intraoperative finding of gangrenous gallbladder.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Intraoperative finding of gangrenous gallbladder.
Mentions: Emergency laparotomy through a midline incision was performed and findings at operation included a large, gangrenous gallbladder with a 360 degree clockwise torsion on its long pedicle. The gallbladder was distinctly suspended free from the liver edge and lying over the greater omentum and transverse colon with some haemorrhagic peritoneal fluid reaction. The torted pedicle was undone and cholecystectomy was performed. The opened gallbladder had complete hemorrhagic infarct with wall thickness of about 1 cm across (Figures 3 &4). The pathological examination of the specimen revealed an 8 cm enlarged gallbladder, 4.5 cm in diameter, with a 1 cm thick oedematous wall with mucosal congestion and the histological findings were consistent with acute gangrenous cholecystitis with extensive necrosis of the wall. Post-operative recovery was uneventful and she was discharged home 8th day post surgery. The delay in discharge was due to social reason.

Bottom Line: Since its first description in 1898 by Wendel there have been over 500 documented cases in the literature.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