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A gallbladder torsion presenting as acute cholecystitis in an elderly woman: A case report.

ABSTRACT: INTRODUCTION: Gallbladder torsion is a rare, but potentially lethal disease, in which early recognition is crucial. CASE PRESENTATION: We describe the case of an 89-year-old Caucasian woman who presented with clinical symptoms suggestive of acute cholecystitis to our hospital. Radiological imaging confirmed our clinical diagnosis. At first we considered percutaneous gallbladder drainage because of her age and comorbidity, but instead performed laparoscopic cholecystectomy because of rapid clinical deterioration. During laparoscopy a necrotic gallbladder due to torsion of the gallbladder around the cystic duct was found. CONCLUSION: Because percutaneous drainage could lead to further deterioration in the case of gallbladder torsion, this rare condition should be considered before performing a percutaneous drainage of cholecystitis.

SUBMITTER: Boer J

PROVIDER: S-EPMC3259112 | biostudies-literature | 2011

REPOSITORIES: biostudies-literature

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A gallbladder torsion presenting as acute cholecystitis in an elderly woman: A case report.

Boer Jorine J Boerma Djamila D de Vries Reilingh Tammo S TS

Journal of medical case reports 20111220

<h4>Introduction</h4>Gallbladder torsion is a rare, but potentially lethal disease, in which early recognition is crucial.<h4>Case presentation</h4>We describe the case of an 89-year-old Caucasian woman who presented with clinical symptoms suggestive of acute cholecystitis to our hospital. Radiological imaging confirmed our clinical diagnosis. At first we considered percutaneous gallbladder drainage because of her age and comorbidity, but instead performed laparoscopic cholecystectomy because of ...[more]

PMID: 22185300

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Project description:BackgroundGallbladder torsion is very rare and easily misdiagnosed as biliary disease. It is defined as the rotation of the gallbladder along the axis of the cystic pedicle on the mesentery. As gallbladder rotation involves the gallbladder artery, the blood supply is blocked, resulting in gallbladder ischemia and eventual necrosis. If misdiagnosis occurs and treatment is delayed, gallbladder torsion can develop into a lethal disease. The typical imaging features of gallbladder torsion in this case are a good learning resource for our young physicians, as well as providing a rare, unusual and typical case for our current literature database.Case descriptionWe present a rare case of gallbladder torsion in a 19-year-old man. The patient complained of sudden recurrent pain and discomfort in the right upper abdomen with vomiting for 12 hours. Abdominal ultrasound and computed tomography (CT) scan showed gallbladder enlargement and signs of acute cholecystitis in emergency examination, and there were no signs of cholecystolithiasis. Considering that the patient was a young male and the patients prefer conservative treatment, symptomatic treatment was given. However, there was no obvious effect after 1 day of medical treatment, but severe abdominal pain in the upper right quadrant continues to progress. Finally, the patient underwent laparoscopic cholecystectomy, and the gallbladder was found to be enlarged with ischemic necrosis, which was caused by gallbladder torsion. The patient recovered 2 days after surgery and was discharged without complications.ConclusionsAlthough the clinical manifestation is similar to that of typical acute calculous cholecystitis, gallbladder torsion can be diagnosed early through some special signs on imaging examination, such as distorted cystic duct signs ("beak and whirl" sign), gallbladder dilatation with gallbladder fossa effusion, and gallbladder in the horizontal position. These signs can help primary surgical treatment and prevent fatal complications such as gallbladder gangrene, perforation, and biliary peritonitis. Therefore, for inexperienced doctors, careful imaging features are required for the correct diagnosis of rare gallbladder torsion.KeywordsGallbladder torsion; acute abdominal disease; cholecystitis; case report.

Dataset Information

A gallbladder torsion presenting as acute cholecystitis in an elderly woman: A case report.

Publications

A gallbladder torsion presenting as acute cholecystitis in an elderly woman: A case report.

Similar Datasets

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