Acute abdominal disease associated with gallbladder torsion recovered after cholecystectomy: a rare case report and literature review br

Wu, Tianchong1,2; Huang, Wenhao3; He, Baochun4; Guo, Yuehua1,2; Peng, Gongzhe1,2; Li, Mingyue1,2; Bao, Shiyun1,2

2022-05-01

10.21037/atm-22-1425

Annals of Translational Medicine   Impact Factor & Quartile

2305-5839

2305-5847

Background: Gallbladder 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 Description: We 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. Conclusions: Although 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

Gallbladder torsion acute abdominal disease cholecystitis case report

SCI

English

Corresponding

Science and Technology Innovation Foundation of Shenzhen["JCYJ20180228164603659","JCYJ20180507182437217"] ; Clinical Research and Cultivation Project of Shenzhen People's Hospital[SYLCYJ202003]

Oncology ; Research & Experimental Medicine

Oncology ; Medicine, Research & Experimental

WOS:000808591800026

AME PUBL CO

Web of Science

1.Jinan Univ, Dept Hepatobiliary & Pancreat Surg, Clin Med Coll 2, Shenzhen Peoples Hosp, Shenzhen, Peoples R China
2.Southern Univ Sci & Technol, Affiliated Hosp 1, Shenzhen, Peoples R China
3.Jinan Univ, Clin Med Coll 2, Shenzhen Peoples Hosp, Shenzhen, Peoples R China
4.Chinese Acad Sci, Shenzhen Inst Adv Technol, Res Lab Med Imaging & Digital Surg, Shenzhen, Peoples R China

Wu, Tianchong,Huang, Wenhao,He, Baochun,et al. Acute abdominal disease associated with gallbladder torsion recovered after cholecystectomy: a rare case report and literature review br[J]. Annals of Translational Medicine,2022,10(10).

Wu, Tianchong.,Huang, Wenhao.,He, Baochun.,Guo, Yuehua.,Peng, Gongzhe.,...&Bao, Shiyun.(2022).Acute abdominal disease associated with gallbladder torsion recovered after cholecystectomy: a rare case report and literature review br.Annals of Translational Medicine,10(10).

Wu, Tianchong,et al."Acute abdominal disease associated with gallbladder torsion recovered after cholecystectomy: a rare case report and literature review br".Annals of Translational Medicine 10.10(2022).