Kohga Atsushi, Okumura Takuya, Suzuki Kenji, Yajima Kiyoshige, Yamashita Kimihiro, Isogaki Jun, Kawabe Akihiro, Kimura Taizo
Division of Surgery, Fujinomiya City General Hospital, Shizuoka 4180076,Japan.
J Surg Case Rep. 2017 Jul 12;2017(7):rjx126. doi: 10.1093/jscr/rjx126. eCollection 2017 Jul.
Strangulation of the gallbladder associated with the omentum is extremely rare and, to our knowledge, only two cases have been previously reported. The patient was a 91-year-old female who presented to our emergency room with a chief complaint of upper abdominal pain. Computed tomography imaging revealed a gourd-shaped gallbladder with biphasic appearance divided clearly at the body. In the fundus side, the wall of the gallbladder was oedematous and thickened, while the neck side was intact. On the second day after onset, a laparoscopic cholecystectomy was performed. A tip of the omentum encircling the gallbladder was adhered to the abdominal wall and was strangling the gallbladder. By cutting the omentum at the attachment site, the strangulation was released. Laparoscopic cholecystectomy was performed, and the patient was discharged with an uneventful course. We experienced an extremely rare case of strangulated gallbladder caused by a tip of the omentum attached to the abdominal wall.
胆囊与大网膜绞窄极为罕见，据我们所知，此前仅报道过两例。该患者为一名91岁女性，因上腹部疼痛为主诉前来我院急诊室就诊。计算机断层扫描成像显示胆囊呈葫芦形，有双相外观，在体部清晰分开。在胆囊底部一侧，胆囊壁水肿增厚，而颈部一侧完好无损。发病后第二天，进行了腹腔镜胆囊切除术。环绕胆囊的大网膜尖端附着于腹壁并绞窄胆囊。通过在附着部位切断大网膜，解除了绞窄。实施了腹腔镜胆囊切除术，患者术后恢复顺利并出院。我们遇到了一例极为罕见的由附着于腹壁的大网膜尖端导致的绞窄性胆囊病例。
