Chai Jia-Sui, Wang Xu, Li Xiao-Zheng, Yao Peng, Yan Zheng-Zheng, Zhang Hong-Jie, Ning Jia-Yong, Cao Yan-Bing
Department of Hepatobiliary Surgery, Yuncheng Central Hospital, the Eighth Clinical College of Shanxi Medical University, Yuncheng 044031, Shanxi Province, China.
Department of General Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, Shanxi Province, China.
World J Clin Cases. 2020 Jun 26;8(12):2667-2673. doi: 10.12998/wjcc.v8.i12.2667.
Gallbladder torsion is a rare acute abdominal condition that requires emergency surgery. It occurs more commonly in elderly people and in women in the adult population. Diagnosis is a challenge as non-specific symptoms and signs have been reported on ultrasonography, computed tomography and magnetic resonance imaging. Prompt cholecystectomy can decrease the mortality and morbidity of perforation due to gallbladder torsion.
An 82-year-old woman with upper-right quadrant pain and associated nausea and vomiting was diagnosed with ectopic acute calculus cholecystitis. Magnetic resonance cholangiopancreatography (MRCP) showed a V-shaped distortion of the extrahepatic bile ducts and a particularly extended twisted cystic duct, which indicated the presence of gallbladder torsion. Emergency laparoscopic cholecystectomy confirmed the diagnosis and the patient recovered without incident.
Gallbladder torsion can be diagnosed pre-operatively by MRCP. The specific signs are a V-shaped distortion of the extrahepatic bile ducts and a particularly extended twisted cystic duct which can be called twisting signs.
胆囊扭转是一种罕见的急腹症，需要紧急手术。它在老年人和成年女性中更为常见。由于超声检查、计算机断层扫描和磁共振成像均报告有非特异性症状和体征，因此诊断颇具挑战。及时行胆囊切除术可降低胆囊扭转所致穿孔的死亡率和发病率。
一名82岁女性，出现右上腹疼痛并伴有恶心呕吐，被诊断为异位急性结石性胆囊炎。磁共振胰胆管造影（MRCP）显示肝外胆管呈V形扭曲，胆囊管特别延长且扭曲，提示存在胆囊扭转。急诊腹腔镜胆囊切除术证实了诊断，患者顺利康复。
胆囊扭转可通过MRCP进行术前诊断。其特异性征象为肝外胆管呈V形扭曲以及胆囊管特别延长且扭曲，可称为扭转征。
