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曲折历程:一位老年患者的胆囊扭转

Twists and Turns: Gallbladder Volvulus in an Elderly Patient.

作者信息

Zillman James C, Aodish Sandres, Dobratz Tyler C, Swaney Patrick, Stivers John

机构信息

School of Medicine, Lake Erie College of Osteopathic Medicine, Erie, USA.

Surgery, Lake Erie College of Osteopathic Medicine, Erie, USA.

出版信息

Cureus. 2024 Jul 29;16(7):e65661. doi: 10.7759/cureus.65661. eCollection 2024 Jul.

Abstract

Gallbladder volvulus (GBV) is a rare medical condition characterized by twisting of the gallbladder around its mesentery. The condition presents with a higher prevalence in older, thin, elderly women and is a challenging diagnosis with nonspecific symptoms often overlapping with acute cholecystitis. Early diagnosis and intervention are critical to prevent complications including ischemia, necrosis, gangrene, perforation, or sepsis. This case is about a 94-year-old woman who presented with epigastric and right upper quadrant pain, nausea, and vomiting with non-specific laboratory results and radiographic findings, leading to an intraoperative diagnosis of GBV. This report underscores the importance of considering GBV in differentials for acute abdominal signs and symptoms and the challenges in diagnosing GBV preoperatively due to its non-specific presentation and, in this case, unrevealing laboratory findings.

摘要

胆囊扭转(GBV)是一种罕见的病症,其特征是胆囊围绕其肠系膜发生扭转。这种病症在老年、消瘦的老年女性中更为常见,并且是一种具有挑战性的诊断,因为其非特异性症状常常与急性胆囊炎重叠。早期诊断和干预对于预防包括缺血、坏死、坏疽、穿孔或脓毒症在内的并发症至关重要。本病例是关于一名94岁女性,她出现上腹部和右上腹疼痛、恶心和呕吐,实验室检查结果和影像学表现均无特异性,导致术中诊断为GBV。本报告强调了在急性腹部体征和症状的鉴别诊断中考虑GBV的重要性,以及由于GBV的非特异性表现(在本病例中实验室检查结果无异常)导致术前诊断GBV存在的挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3dd/11352764/80a3e59d7ad5/cureus-0016-00000065661-i01.jpg

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