Resumo
A case of torsion of the gallbladder is presented. This is a rare condition that occurs when it is associated with anatomical variants related to abnormal fixation of the gallbladder to the liver bed. The blood irrigation is insufficient and the gallbladder develops necrosis. The abnormal implantation occurs in 4% of the population. If the gallbladder losses its fixations to the inferior margin of the liver with the presence of a 1011.g mesocyst a torsion can occur when this gallbladder twists axially with subsequent occlusion of the blood flow. The signs and symptoms are similar to those of severe acute cholecystitis: abrupt onset of the pain and large palpable mass below the right costal margin. The ultrasound can show a very large and anteriorly floating gallbladder: In this case, the ultrasound did not show any abnormal signs, so it is usually diagnosed at laparotomy and the treatement consists of cholecystectomy. This condition should be suspected in acute abdominal pain of unknown origin.
Gallbladder volvulus; Torsion
Gallbladder volvulus; Torsion
RELATOS DE CASO
Volvo da vesícula biliar
Gallbladder volvulus
Luiz Antonio Rodrigues, TCBC-RJI; Francisco de Assis David Cruz Silva, ACBC-RJII
ICirurgião do Hospital Central do Exército, ex-Diretor do Hospital Estadual Getúlio Vargas
IICirurgião do Hospital Central do Exército
Endereço para correspondência Endereço para correspondência: Dr. Luiz Antônio Rodrigues Rua Cardoso de Moraes, 61/526 21032-000 - Rio de Janeiro - RJ
ABSTRACT
A case of torsion of the gallbladder is presented. This is a rare condition that occurs when it is associated with anatomical variants related to abnormal fixation of the gallbladder to the liver bed. The blood irrigation is insufficient and the gallbladder develops necrosis. The abnormal implantation occurs in 4% of the population. If the gallbladder losses its fixations to the inferior margin of the liver with the presence of a 1011.g mesocyst a torsion can occur when this gallbladder twists axially with subsequent occlusion of the blood flow. The signs and symptoms are similar to those of severe acute cholecystitis: abrupt onset of the pain and large palpable mass below the right costal margin. The ultrasound can show a very large and anteriorly floating gallbladder: In this case, the ultrasound did not show any abnormal signs, so it is usually diagnosed at laparotomy and the treatement consists of cholecystectomy. This condition should be suspected in acute abdominal pain of unknown origin.
Key words: Gallbladder volvulus; Torsion.
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Recebido em 29/3/99
Aceito para publicação em 20/9/99
Trabalho realizado no Serviço de Cirurgia Geral do Hospital Central do Exército.
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- 3. Gugenheim J, Baldini E, Casaccia M, Mouiel - Volvulus of the gallbladder: a difficult diagnosis requirig urgent operation. Gastroenterol-Clin-Biol 1997 ;21 (12):999-1000
- 4. Garcia Picazo D, Palomares Ortiz G, Capilla F et al- Acute volvulus of the gallbladder. Gastrenterol Hepatol1996; 19 (6):334
- 5. Merriman TE, Houghtan G, Ventura R - Tarsian af the fundus af the gallbladder. Aust N Z J Surg 1993;63 (10): 821-2
Endereço para correspondência:
Datas de Publicação
-
Publicação nesta coleção
24 Nov 2009 -
Data do Fascículo
Dez 1999
Histórico
-
Aceito
20 Set 1999 -
Recebido
29 Mar 1999
