術前診断し得た胆嚢捻転症の１例

We report on a case of torsion of the gallbladder, whitch was correctly diagnosed preoperatively using pre-operative imaging with ultrasound and computed tomography. A 88-year-old woman was admitted to the hospital because of diarrhea and fever. Increased levels of WBC, CRP were noted in laboratory test. An Abdominal ultrasound showed a swollen gallbladder with a thicked wall in the body and funds, floating gallbladder and a high echo level lesion with an acoustic shadow in the gallbladder. Abdominal computed tomography showed a gallbladder with a spirally twisted neck and small gass lesion. Diagnostic imaging demonstrated acute inflammatory changes in the gallbladder with an abnormal arrangement of the gallbladder. These results suggested necrotizing cholecystitis with tortion of the gallbladder. During the operation, the gallbladder was found to be enlarged and twisted 360 degrees in a clockwise direction at the neck of the gallbladder, resulting in gangrenous change. A cholecystectomy was successfully performed and the patient was discharged in good condition, 23 days after the operation.

四国医学雑誌 : http://www.tokushima-u.ac.jp/med/research/shikoku_acta_medica.html