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Title: Gallbladder Volvulus: A Rare Emergent Cause of Acute Cholecystitis, if Untreated, Progresses to Necrosis and Perforation

An 86 year-old woman with a past medical history significant for abdominal hernia and Alzheimer dementia presented to the Emergency Department with a 24 hour history of acute right upper quadrant pain associated with nausea and non-bilious emesis. Physical exam revealed right sided abdominal tenderness with associated mass. All laboratory values were within normal ranges. Both abdominal ultrasound and computed tomography of the abdomen/pelvis revealed a large distended gallbladder with wall thickening and gallstones. Based on presentation and radiologic findings, the emergency general surgery service was consulted for suspected acute cholecystitis. The patient was then admitted for intravenous antibiotics and scheduled for laparoscopic cholecystectomy the following day. Intra-operative findings revealed volvulus with acute necrosis of the entire gallbladder. The gallbladder had a long pedunculated cystic duct and artery that was detorsed before proceeding with resection. Postoperatively, the patient did well and was discharged a few days later tolerating a regular diet.
Authors:
;  [1]
  1. Department of Surgery, Baylor Scott and White Health and Texas A&M Health Science Center College of Medicine, Temple, TX (United States)
Publication Date:
OSTI Identifier:
22504542
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Clinical and Medical Imaging; Journal Volume: 3; Journal Issue: 3; Other Information: PUBLISHER-ID: 2376-0249.1000439; Copyright: (c) 2016 Regner JL Lomas A.; This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABDOMEN; ANTIBIOTICS; ARTERIES; BILIARY TRACT; CALCULI; COMPUTERIZED TOMOGRAPHY; NAUSEA; NECROSIS; NERVOUS SYSTEM DISEASES; PAIN; PATIENTS; PELVIS; PERFORATION; SURGERY; UROGENITAL SYSTEM DISEASES; WOMEN