부산대학교 도서관

The development of medical imaging technologies has improved the clinical diagnostic accuracy of gallbladder torsion with some typical findings. It is however still difficult to diagnose preoperatively in some cases. We report herein on a case of gallbladder torsion in an elderly woman whose preoperative diagnosis were moderate acute cholecystitis and review the clinical aspect of gallbladder torsion. A 90-year-old female was admitted to our hospital with a 2-day history of right abdominal pain. Clinical examination revealed tenderness in the right upper and lower quadrant area with a palpable round mass. Abdominal US and CT showed a distended, thick-walled gallbladder with gallstones, common bile duct stones and pericholecystic fluid. From these findings, we made the diagnosis of moderate acute cholecystitis and performed a laparoscopic cholecystectomy. Intra-operatively, the gallbladder that was necrotic and gangrenous had undergone a 360-degree anti-clockwise torsion. The postoperative course was favorable. Since some clinical and imaging findings are the same in acute cholecystitis and gall bladder torsion, it is important to have knowledge of the typical findings of gallbladder torsion and to make a preoperative diagnosos.