Gallbladder torsion with gangrenous cholecystitis: a case report

Abstract A woman in her nineties presented with a 7-day history of right upper quadrant pain, nausea and anorexia. Examination findings included tenderness in the right upper quadrant and a positive Murphy’s sign. Laboratory studies were unremarkable with normal white cell count, C-reactive protein...

Full description

Saved in:
Bibliographic Details
Published in:Journal of surgical case reports 2023-05, Vol.2023 (5), p.rjad252
Main Authors: Daly, Tessa, Byrne, Jim, Aftab, Fuad
Format: Article
Language:English
Subjects:
Case Report
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract A woman in her nineties presented with a 7-day history of right upper quadrant pain, nausea and anorexia. Examination findings included tenderness in the right upper quadrant and a positive Murphy’s sign. Laboratory studies were unremarkable with normal white cell count, C-reactive protein and liver functions tests. Ultrasound of the abdomen, however, demonstrated a distended gallbladder containing sludge and a thickened gallbladder wall. The patient’s symptoms worsened with associated elevation of inflammatory markers despite initial treatment with intravenous antibiotics for 24 h. It was decided to proceed to laparoscopic cholecystectomy. Intraoperatively, 360° clockwise torsion of a gangrenous gallbladder on an elongated mesentery was noted. Laparoscopic cholecystectomy was completed without complication and the patient was discharged home after completion of a course of intravenous antibiotics. Histopathological examination demonstrated acute cholecystitis with extensive mural necrosis.
ISSN:2042-8812
2042-8812
DOI:10.1093/jscr/rjad252