Alfonso VJM, Domínguez RDL, Correa ML, Piñero PR

Language: Spanish
References: 9
Page: 380-384
PDF size: 197.70 Kb.

ABSTRACT

Introduction: gallbladder volvulus is an unusual and rare occurrence entity of difficult preoperative diagnosis, with a predilection for women in their seventh or eight decades of life. For the first time a case is reported in Pinar del Rio province, and the second recorded in the review conducted in the national statistics records.
Clinical case: a 90-year-old female, Caucasian patient, who attended the emergency room affected by a dull abdominal pain, with two days of evolution, increasing gradually, located in the right upper quadrant and right iliac fossa without other associated symptoms. Abdominal palpation shows a superficial and deep pain in right hypochondriac region and right iliac fossa , with signs of peritoneal response. Palpable mass is also noticed in RIF, movable and firm, which exacerbated pain during exploration. It was decided to perform emergency surgery by means of video laparoscopy, a gangrenous and gallbladder volvulus was visualized. Proceeding to remove the volvulus, cystic artery and cystic duct were displayed, dissected, clipped and cut separately; the acute gallbladder volvulus was successfully treated with cholecystectomy.The patient had a good progress and was discharged.
Conclusions: gallbladder volvulus is a rare entity, predominantly in female patients of geriatric ages, clinical diagnosis is difficult and it usually occurs as a peritoneal syndrome, complementary imaging can help to reach to a definitely diagnosis, the evolution is favorable.

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