Presentation
A 87 year old patient presented with intense right upper quadrant pain, anorexia, nausea and vomiting. Murphy's sign was present at physical examination. Hemogram showed 9.200 leukocytes/mm³, with six bands. [scienceopen.com]
Clinically it presents as an acute cholecystitis, usually a less aggressive and serious illness than gallbladder volvulus. [scielo.isciii.es]
J Reprod Med 34:299–300 PubMed CAS Google Scholar Kubota A, Nakayama T, Yonekura T et al (2000) Congenital ileal atresia presenting as a single cyst-like lesion on prenatal sonography. [link.springer.com]
Gastrointestinal
- Acute Abdomen
Its presentation as an acute abdomen episode is exceptional (1-5). We report the case of a 95 year old man with suspected acute appendicitis in the context of an acute abdomen episode who was found to have a gallbladder volvulus during surgery. [scielo.isciii.es]
Liver, Gall & Pancreas
- Murphy's Sign
Murphy's sign was present at physical examination. Hemogram showed 9.200 leukocytes/mm³, with six bands. Ultrassonography showed a distended gallbladder, perivesicular fluid collection, wall edema, and sludge with stones inside. [scienceopen.com]
Workup
Laboratory
- Leukocytosis
If there is fever or leukocytosis, then acute cholecystitis may have developed. It has been observed on patients with significant weight loss, in which there is loss of pericholecystic fat. [radiopaedia.org]
Blood test showed leukocytosis (12.500/mm3) with neutrophilia (85%). CT scan of the abdomen demonstrated an intra abdominal collection in the right iliac fossa and right parietocolic space. [scielo.isciii.es]
Treatment
Emergency detorsion and open or laparoscopic cholecystectomy remain as the treatment of choice (1-5). [scielo.isciii.es]
[…] anatomical fossa change in anatomical orientation, from vertical to horizontal 3 indrawing of the vascular pedicle and surrounding fat ("swirl" sign) 4 loss of enhancement abrupt tapering of cystic duct ("bird beak" sign) Cholecystectomy is the preferred treatment [radiopaedia.org]
In: Harrison MR, Golbus MS, Filly RA (eds) The unborm patient, antenatal diagnosis and treatment. WB Saunders, Philadelphia, pp 593–648 Google Scholar Wang YJ, Chen FIC, Chi CS (1994) Meconium peritonitis in neonates. [link.springer.com]
Prognosis
Year Book Medical Publisher, Chicago-London Google Scholar Ein SH, Shandling B, Wesson D et al (1989) Esophageal atresia with distal tracheoesophageal fistula: associated anomalies and prognosis in the 1980s. [link.springer.com]
Etiology
Although the etiology is unknown, certain predisposing factors have been identified. Of these, the only one that is constant is the presence of the gallbladder on a mobile mesentery ("floating" gallbladder). [scienceopen.com]
Epidemiology
J Pediatr Surg 34:834–836 CrossRef PubMed CAS Google Scholar Cragun JD, Martin ML, Moore CA (1993) Descriptive epidemiology of small intestinal atresia. [link.springer.com]
Prevention
J Obstet Gynaecol Res 26:89–93 CrossRef PubMed CAS Google Scholar Martinez Ferro M, Bailez M (1998) Fetal ovarian cyst decompression to prevent torsion. [link.springer.com]