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胆囊扭转:保守治疗胆囊炎时的必要考量因素

Gallbladder Volvulus: A Necessary Consideration When Managing Cholecystitis Conservatively.

作者信息

Mealy Anna, Fisher Mikhail

机构信息

General Surgery, Monash Health, Melbourne, AUS.

出版信息

Cureus. 2025 Jun 30;17(6):e87080. doi: 10.7759/cureus.87080. eCollection 2025 Jun.

DOI:10.7759/cureus.87080
PMID:40746802
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12311319/
Abstract

Gallbladder volvulus is a rare surgical pathology predominantly affecting an older patient profile, in which frailty and comorbidities play an important role in surgical decision-making. The difficulty in accurately diagnosing this condition lies in the vague, non-specific symptoms and the lack of a reliable radiological diagnosis. This case report describes the management of gallbladder volvulus in a 91-year-old female and highlights the fact that antibiotics alone will not manage this pathology. Therefore, this condition must be part of the differential diagnosis when considering conservative management of cholecystitis.

摘要

胆囊扭转是一种罕见的外科病理情况,主要影响老年患者群体,其中身体虚弱和合并症在手术决策中起着重要作用。准确诊断这种疾病的困难在于症状模糊、不具特异性,且缺乏可靠的影像学诊断方法。本病例报告描述了一名91岁女性胆囊扭转的治疗情况,并强调仅使用抗生素无法治疗这种病理状况。因此,在考虑胆囊炎的保守治疗时,必须将这种情况纳入鉴别诊断范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6ab/12311319/57c648ea7e8b/cureus-0017-00000087080-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6ab/12311319/0a5caffd8240/cureus-0017-00000087080-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6ab/12311319/e0b57af8bd89/cureus-0017-00000087080-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6ab/12311319/57c648ea7e8b/cureus-0017-00000087080-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6ab/12311319/0a5caffd8240/cureus-0017-00000087080-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6ab/12311319/e0b57af8bd89/cureus-0017-00000087080-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6ab/12311319/57c648ea7e8b/cureus-0017-00000087080-i03.jpg

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本文引用的文献

1
Gallbladder volvulus with gangrenous cholecystitis - A case report.胆囊扭转伴坏疽性胆囊炎——病例报告
Int J Surg Case Rep. 2022 Aug;97:107468. doi: 10.1016/j.ijscr.2022.107468. Epub 2022 Jul 30.
2
Gallbladder Volvulus: A Review.胆囊扭转:综述
Cureus. 2022 Mar 21;14(3):e23362. doi: 10.7759/cureus.23362. eCollection 2022 Mar.
3
Gallbladder Torsion Masking as Acalculus Cholecystitis: A Review of Two Cases Including Unsuccessful Management With Percutaneous Cholecystostomy.胆囊扭转伪装成无结石性胆囊炎:两例病例回顾,包括经皮胆囊造瘘术治疗失败
J Med Cases. 2021 Jun;12(6):223-225. doi: 10.14740/jmc3683. Epub 2021 Mar 20.
4
The diagnostic dilemma of a gallbladder volvulus: An unusual case report and review of the literature.胆囊扭转的诊断困境:一例罕见病例报告及文献综述
Int J Surg Case Rep. 2021 Mar;80:105614. doi: 10.1016/j.ijscr.2021.01.108. Epub 2021 Feb 3.
5
Management of acute cholecystitis in elderly patients: A propensity score-matched analysis of surgical vs. medical treatment.老年患者急性胆囊炎的治疗:手术与药物治疗的倾向评分匹配分析。
Dig Liver Dis. 2021 Dec;53(12):1620-1626. doi: 10.1016/j.dld.2021.01.011. Epub 2021 Jan 23.
6
Expect the Unexpected: Torsion of the Gallbladder, a Rare Cause for Acute Cholecystitis.意料之外:胆囊扭转,急性胆囊炎的罕见病因。
Cureus. 2018 Dec 13;10(12):e3726. doi: 10.7759/cureus.3726.
7
Gangrenous cholecystitis: mortality and risk factors.坏疽性胆囊炎:死亡率及危险因素
Int Surg. 2015 Feb;100(2):254-60. doi: 10.9738/INTSURG-D-13-00222.1.
8
Torsion of the gallbladder: a systematic review.胆囊扭转:系统评价。
HPB (Oxford). 2012 Oct;14(10):669-72. doi: 10.1111/j.1477-2574.2012.00513.x. Epub 2012 Jul 3.
9
Acute acalculous cholecystitis: challenging the myths.急性非结石性胆囊炎:挑战传统观念。
HPB (Oxford). 2007;9(2):131-4. doi: 10.1080/13651820701315307.
10
Gallbladder torsion: case report and review of 245 cases reported in the Japanese literature.胆囊扭转:病例报告及对日本文献报道的245例病例的回顾
J Hepatobiliary Pancreat Surg. 1999;6(4):418-21. doi: 10.1007/s005340050143.