Lemonick David M, Garvin Robert, Semins Howard
Department of Emergency Medicine, The Western Pennsylvania Hospital, 4800 Friendship Avenue, Pittsburgh, Pennsylvania, USA.
J Emerg Med. 2006 May;30(4):397-401. doi: 10.1016/j.jemermed.2005.07.011.
We present a case of acute torsion of the gallbladder in a young woman. Approximately 400 cases have been reported since 1898, mostly in elderly women, and the incidence appears to be increasing. The anatomy and pathophysiology that predispose patients to this rare surgical emergency are discussed. Several clinical and imaging findings can be used to distinguish gallbladder torsion from typical acute cholecystitis. By recognizing and treating gallbladder torsion early in its course, a low surgical morbidity and mortality can be achieved. The case presented highlights for emergency physicians some of the considerations in identification of patients with acute cholecystitis who are at highest risk of gangrene and perforation, their emergency treatment, and the timing of surgery.
我们报告了一例年轻女性急性胆囊扭转的病例。自1898年以来，大约已报告了400例，大多数为老年女性，且发病率似乎在上升。文中讨论了使患者易患这种罕见外科急症的解剖学和病理生理学。一些临床和影像学表现可用于鉴别胆囊扭转与典型的急性胆囊炎。通过在病程早期识别并治疗胆囊扭转，可实现较低的手术发病率和死亡率。所呈现的病例为急诊医生强调了一些在识别急性胆囊炎患者中发生坏疽和穿孔风险最高者时的注意事项、他们的急诊治疗以及手术时机。
