Komura J, Yano H, Tanaka Y, Tsuru T
Department of Pediatric Surgery, Kurume University School of Medicine, Japan.
Kurume Med J. 1993;40(1):13-6. doi: 10.2739/kurumemedj.40.13.
Torsion of the gallbladder in a child is rare and only 23 cases in children have been reported in Japan. A preoperative diagnosis is very difficult and only four cases have been diagnosed, preoperatively, to date. In the case reported here the suspected preoperative diagnosis was an acute cholecystitis. During the operation, the gallbladder was found to be enlarged to twice the normal size and twisted 540 degrees in a clockwise direction around the cystic duct. A cholecystectomy with abdominal drainage was successfully performed; and the patient was discharged in good condition, 13 days after the operation. It was concluded that one of the most important features for the preoperative diagnosis of torsion of the gallbladder is a dislocation on ultrasonography.
小儿胆囊扭转罕见,日本仅报道过23例小儿病例。术前诊断非常困难,迄今为止术前仅确诊4例。在本文报道的病例中,术前疑似诊断为急性胆囊炎。手术中发现胆囊增大至正常大小的两倍,并沿胆囊管顺时针扭转540度。成功实施了胆囊切除术并进行了腹腔引流;患者术后13天康复出院,状况良好。得出的结论是,超声检查显示的移位是胆囊扭转术前诊断的最重要特征之一。