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The deceitful diagnosis of gallbladder volvulus: A case report

INTRODUCTION AND IMPORTANCE: The gallbladder volvulus is a rare but life-threatening condition characterized by an axial torsion of the gallbladder along the cystic pedicle, causing gallbladder ischemia and necrosis. This paper aims to present and discuss a rare case of gallbladder volvulus. This ca...

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Autores principales: Mejri, Atef, Arfaoui, Khaoula, Rchidi, Jasser, Omry, Ahmed, Mseddi, Mohamed Ali, Saad, Sarra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8213891/
https://www.ncbi.nlm.nih.gov/pubmed/34139416
http://dx.doi.org/10.1016/j.ijscr.2021.106114
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author Mejri, Atef
Arfaoui, Khaoula
Rchidi, Jasser
Omry, Ahmed
Mseddi, Mohamed Ali
Saad, Sarra
author_facet Mejri, Atef
Arfaoui, Khaoula
Rchidi, Jasser
Omry, Ahmed
Mseddi, Mohamed Ali
Saad, Sarra
author_sort Mejri, Atef
collection PubMed
description INTRODUCTION AND IMPORTANCE: The gallbladder volvulus is a rare but life-threatening condition characterized by an axial torsion of the gallbladder along the cystic pedicle, causing gallbladder ischemia and necrosis. This paper aims to present and discuss a rare case of gallbladder volvulus. This case report has been reported in line with the SCARE criteria 2020 [1]. CASE PRESENTATION: We report the case of a 90-year-old female patient who presented to the emergency room with sharp right upper abdominal quadrant pain of acute onset associated with vomiting, evolving for the last 12 h. She had no fever nor jaundice. Her body mass index (BMI) was 22. She had kyphosis, and scoliosis. Physical examination found tenderness with a palpable mass in the right upper abdominal quadrant. Laboratory test results showed leukocytosis at 11600 /mL and a high C-reactive protein rate at 40 mg/L revealed acute calculous cholecystitis features. However, emergency laparotomy was performed and discovered a gallbladder volvulus. A detorsion and cholecystectomy were performed with a good outcome. CLINICAL DISCUSSION: The preoperative diagnosis of gallbladder volvulus is difficult due to its misleading clinical presentation mimicking acute cholecystitis. The presence of the three highly suggestive triad clinical signs should encourage the radiologist to search for a gallbladder with a horizontal orientation and located outside its anatomical fossa connected to the liver by a conical structure corresponding to the twisted pedicle in ultrasonography. Unlike ordinary acute cholecystitis, which may sometimes tolerate an initial conservative medical treatment, gallbladder volvulus management is always an emergency cholecystectomy. CONCLUSION: Despite the clinical similarities with the classical acute calculous cholecystitis, gallbladder volvulus is more likely to result in fatal outcome. Therefore, a high level of clinical suspicion is necessary to save lives.
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spelling pubmed-82138912021-06-25 The deceitful diagnosis of gallbladder volvulus: A case report Mejri, Atef Arfaoui, Khaoula Rchidi, Jasser Omry, Ahmed Mseddi, Mohamed Ali Saad, Sarra Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: The gallbladder volvulus is a rare but life-threatening condition characterized by an axial torsion of the gallbladder along the cystic pedicle, causing gallbladder ischemia and necrosis. This paper aims to present and discuss a rare case of gallbladder volvulus. This case report has been reported in line with the SCARE criteria 2020 [1]. CASE PRESENTATION: We report the case of a 90-year-old female patient who presented to the emergency room with sharp right upper abdominal quadrant pain of acute onset associated with vomiting, evolving for the last 12 h. She had no fever nor jaundice. Her body mass index (BMI) was 22. She had kyphosis, and scoliosis. Physical examination found tenderness with a palpable mass in the right upper abdominal quadrant. Laboratory test results showed leukocytosis at 11600 /mL and a high C-reactive protein rate at 40 mg/L revealed acute calculous cholecystitis features. However, emergency laparotomy was performed and discovered a gallbladder volvulus. A detorsion and cholecystectomy were performed with a good outcome. CLINICAL DISCUSSION: The preoperative diagnosis of gallbladder volvulus is difficult due to its misleading clinical presentation mimicking acute cholecystitis. The presence of the three highly suggestive triad clinical signs should encourage the radiologist to search for a gallbladder with a horizontal orientation and located outside its anatomical fossa connected to the liver by a conical structure corresponding to the twisted pedicle in ultrasonography. Unlike ordinary acute cholecystitis, which may sometimes tolerate an initial conservative medical treatment, gallbladder volvulus management is always an emergency cholecystectomy. CONCLUSION: Despite the clinical similarities with the classical acute calculous cholecystitis, gallbladder volvulus is more likely to result in fatal outcome. Therefore, a high level of clinical suspicion is necessary to save lives. Elsevier 2021-06-11 /pmc/articles/PMC8213891/ /pubmed/34139416 http://dx.doi.org/10.1016/j.ijscr.2021.106114 Text en © 2021 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Mejri, Atef
Arfaoui, Khaoula
Rchidi, Jasser
Omry, Ahmed
Mseddi, Mohamed Ali
Saad, Sarra
The deceitful diagnosis of gallbladder volvulus: A case report
title The deceitful diagnosis of gallbladder volvulus: A case report
title_full The deceitful diagnosis of gallbladder volvulus: A case report
title_fullStr The deceitful diagnosis of gallbladder volvulus: A case report
title_full_unstemmed The deceitful diagnosis of gallbladder volvulus: A case report
title_short The deceitful diagnosis of gallbladder volvulus: A case report
title_sort deceitful diagnosis of gallbladder volvulus: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8213891/
https://www.ncbi.nlm.nih.gov/pubmed/34139416
http://dx.doi.org/10.1016/j.ijscr.2021.106114
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