Lau W Y, Fan S T, Wong S H
Aust N Z J Surg. 1982 Oct;52(5):492-4. doi: 10.1111/j.1445-2197.1982.tb06036.x.
Three cases of torsion of the gall bladder in the aged are presented. From a review of the clinical features of these cases and the cases reported in the literature, a definite clinical pattern emerged. The clinical features can be grouped into three triads: a triad of the patient's characteristics which consists of a thin, old patient with chronic chest disease or a deformed spine; a triad of symptoms which consists of typical abdominal pain, early onset of vomiting and a short history; and a triad of physical signs which consists of an abdominal mass, a lack of toxaemia or jaundice and a discrepancy in the pulse and temperature. If most, if not all, of these features are present, torsion of the gall bladder should be presented. We re-emphasize that a clinical suspicion or diagnosis of torsion of the gall bladder is possible. The treatment is early cholecystectomy.
本文报告了3例老年胆囊扭转病例。通过对这些病例以及文献报道病例的临床特征进行回顾，得出了明确的临床模式。临床特征可分为三个三联征：患者特征三联征，包括消瘦的老年患者，伴有慢性胸部疾病或脊柱畸形；症状三联征，包括典型的腹痛、早期呕吐和病程短；体征三联征，包括腹部肿块、无全身中毒症状或黄疸以及脉搏和体温异常。如果出现这些特征中的大部分（即使不是全部），应考虑胆囊扭转。我们再次强调，胆囊扭转有可能通过临床怀疑或诊断出来。治疗方法是早期胆囊切除术。
