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在发病后第五天通过腹腔镜手术治疗胆囊扭转。

Gallbladder torsion treated with laparoscopic surgery on the fifth day after onset.

作者信息

Takematsu Toru, Ikeda Asuka, Fukunaga Ryota, Kishikawa Keiji, Imamura Ichiro

机构信息

Department of Gastroenterological Surgery, Imamura Hospital, 1523-6 Todoroki-cho, Saga 841-0061, Japan.

出版信息

J Surg Case Rep. 2025 Aug 12;2025(8):rjaf620. doi: 10.1093/jscr/rjaf620. eCollection 2025 Aug.

Abstract

Gallbladder torsion is a rare condition and has very similar symptoms to acute cholecystitis and is often difficult to diagnose preoperatively. We report the case of a patient who was initially diagnosed with cholecystitis and subsequently underwent surgery with a diagnosis of gallbladder torsion on the fifth day after onset. An 83-year-old woman presented with a 2-day history of gradually progressive lower abdominal pain. Computed tomography showed a gallstone and an enlarged gallbladder. We diagnosed the patient with gallstone cholecystitis and admitted her to hospital. As the abdominal pain had not improved by the next day, we performed a laparoscopic cholecystectomy on the fifth day onset. Intraoperative findings confirmed necrosis of the gallbladder and torsion at the gallbladder neck. Gallbladder torsion may be misdiagnosed as acute cholecystitis. When abdominal symptoms are not severe as in our case, semi-emergency surgery may be a viable option.

摘要

胆囊扭转是一种罕见病症,其症状与急性胆囊炎非常相似,术前常难以诊断。我们报告一例患者,最初被诊断为胆囊炎,发病后第五天手术时确诊为胆囊扭转。一名83岁女性,有2天逐渐加重的下腹痛病史。计算机断层扫描显示有胆结石和胆囊增大。我们诊断该患者为结石性胆囊炎并收治入院。次日腹痛未改善,发病第五天我们进行了腹腔镜胆囊切除术。术中发现证实胆囊坏死及胆囊颈部扭转。胆囊扭转可能被误诊为急性胆囊炎。当腹部症状不像我们病例中那样严重时,半急诊手术可能是一种可行的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d05/12343089/7aa303c33e83/rjaf620f1.jpg

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