Keeratibharat Nattawut, Chansangrat Jirapa
School of Surgery, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, THA.
School of Radiology, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, THA.
Cureus. 2022 Jan 15;14(1):e21275. doi: 10.7759/cureus.21275. eCollection 2022 Jan.
The gallbladder volvulus is a rare entity of acute abdomen and a life-threatening condition that requires urgent surgery. The etiology of gallbladder volvulus is still unclear, and there is intraoperative evidence of a floating gallbladder that leads to a twisting of its pedicle, thus causing gallbladder ischemia and necrosis. Gallbladder volvulus is more frequently encounter in elderly females. We report a case of a 27-year-old female who presented with a clinical manifestation consistent with acute cholecystitis. Radiologic finding demonstrated displacement of the gallbladder body and fundus from the gallbladder fossa into the gastrohepatic recess. An emergency laparoscopic cholecystectomy was performed, and intraoperative findings revealed a gangrenous free-floating gallbladder that displaced to the dorsal sector of the left lobe liver. The critical view of safety was able to identify clearly and the gallbladder was removed safely with laparoscopic approach. While many previous cases have been reported, diagnosis of gallbladder volvulus remains difficult especially in young adults. Prompt diagnosis and surgery in cases of acute cholecystitis due to gallbladder volvulus are important to avoid gallbladder necrosis and perforation and result in a good outcome.
胆囊扭转是一种罕见的急腹症，是一种危及生命的疾病，需要紧急手术。胆囊扭转的病因尚不清楚，术中可见胆囊漂浮，导致其蒂部扭转，从而引起胆囊缺血坏死。胆囊扭转在老年女性中更为常见。我们报告一例27岁女性，其临床表现与急性胆囊炎一致。影像学检查发现胆囊体和底部从胆囊窝移位至肝胃隐窝。行急诊腹腔镜胆囊切除术，术中发现一个坏疽的游离漂浮胆囊，移位至左叶肝背侧。安全关键视野清晰可辨，采用腹腔镜方法安全切除胆囊。虽然之前已经报道了许多病例，但胆囊扭转的诊断仍然困难，尤其是在年轻人中。对于因胆囊扭转导致的急性胆囊炎，及时诊断和手术对于避免胆囊坏死和穿孔并取得良好预后很重要。
