Korean J Hepatobiliary Pancreat Surg.  2015 May;19(2):82-85. 10.14701/kjhbps.2015.19.2.82.

A rare case of gallbladder torsion along the axis of body: a case report

• Kwon HJ
• Kim SG

• KMID: 2243055
• DOI: http://doi.org/10.14701/kjhbps.2015.19.2.82

Abstract

Abnormal attachment of the gallbladder to the liver is the main cause for gallbladder torsion. However, the present study reports a rare case of gallbladder torsion in which a portion of fundus is rotated along the axis of body. So far, very few similar cases have been reported. An 87-year-old woman complaining right upper quadrant abdominal pain for 4 days was admitted. Her body temperature was 38.5degrees C with moderate dehydration. A large tender mass was palpated on the right abdomen extending to the right iliac fossa. Computed tomography of abdomen showed a large cavity with a diameter of 15 cm containing a big stone and a small normal looking gallbladder. Ultrasonographic scan showed a twisted portion of the gallbladder torsion. During emergency laparotomy, the middle portion of the gallbladder was found to be twisted counterclockwise with huge gangrenous gallbladder distal. The proximal body of the gallbladder was spared and attached firmly to the liver. Cholecystectomy was performed and the patient was discharged 2 weeks later without postoperative complications. Histological findings of specimen were consistent with operative findings. The current study reports on a rare case of gallbladder torsion by reviewing previous studies.

Keyword

Gallbladder; Torsion; Gallstones; Cholecystectomy; Emergencies

MeSH Terms

Abdomen
Abdominal Pain
Aged, 80 and over
Axis, Cervical Vertebra
Body Temperature
Cholecystectomy
Dehydration
Emergencies
Female
Gallbladder*
Gallstones
Humans
Laparotomy
Liver
Postoperative Complications

Figure

• 

  Fig. 1 Imaging and operative findings. (A) The large cavity with largest diameter of 15 cm had wall thickening containing large stone. (B) Doppler ultrasonography confirmed blood flow in the gallbladder proximal to the twisted portion but no blood flow in the distal huge cavity. (C) The surgical specimen showed a normal cystic duct, gallbladder neck, and proximal body attached firmly on the gallbladder bed.tThe distal portion of gallbladder was twisted 360 degree in counterclockwise direction around the axis of the gallbladder. (D) The illustration shows torsion of the fundus along the axis of the body in the counterclockwise direction.

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