A CASE OF TORSION OF THE GALLBLADDER IN WHICH TORSION WAS REDUCED PREOPERATIVELY

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  • YAMACHIKA Daisuke
    Department of Gastroenterological Surgery, Tokai University School of Medicine
  • DOWAKI Shoichi
    Department of Gastroenterological Surgery, Tokai University School of Medicine
  • YAZAWA Naoki
    Department of Gastroenterological Surgery, Tokai University School of Medicine
  • IMAIZUMI Toshihide
    Department of Gastroenterological Surgery, Tokai University School of Medicine
  • MAKUUCHI Hiroyasu
    Department of Gastroenterological Surgery, Tokai University School of Medicine

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  • 術前に捻転が解除された胆嚢捻転症の１例

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Abstract

A 38-year-old man was seen at the hospital because of the abrupt onset of epigastric pain. An abdominal ultrasonic examination showed a swollen gallbladder which had deviated toward the midline. An abdominal CT scan revealed the gallbladder just under the median abdominal wall, and MRCP showed the gallbladder on the left side of the common bile duct. Accordingly torsion of the gallbladder was diagnosed and an emergency operation was scheduled. Another ultrasonic study done before surgery revealed that the gallbladder had replaced to the gallbladder bed from the midline when abdominal pain disappeared. Another abdominal CT scan and MRCP also showed the gallbladder in the normal position. No findings suggestive of necrosis of the gallbladder were noted, and hence laparoscopic cholecystectomy was performed on the 4th hospital day. Intraoperative findings revealed that the gallbladder involved necrotic parts and the gallbladder bed berely attached. The postoperative course was uneventful and the patient was discharged from the hospital on the 8th hospital day.<BR>Even in a case in which torsion of the gallbladder is once reduced, we must keep a possibility of gallbladder necrosis in mind and promptly perform surgery.

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