Abstract
A 22-year-old man visited our hospital complaining of abdominal pain and fever. Laboratory data were within the normal range. Abdominal X-ray examination did not revealed any abnormal signs. Abdominal enhanced CT demonstrated that the fundus of the gallbladder was located to the left side of the gallbladder bed as a sign of a floating gallbladder. In addition, gallbladder torsion was strongly suggested by the following findings: (1)narrow segment between the neck and body of the gallbladder, (2)thickening of the wall only of the gallbladder body and fundus, and (3)increased fluid density in the contents of the gallbladder body and fundus, but not the neck. From these characteristic findings, we diagnosed this as acute necrotic cholecystitis due to torsion. Emergency laparoscopic cholecystectomy was performed without difficulty. The postoperative course was uneventful. Most cases of gallbladder torsion are seen in the elderly but rarely in juveniles. We report herein on a juvenile case which was successfully diagnosed with CT and treated with emergency laparoscopic cholecystectomy. Precise CT examination is important to diagnose torsion of the gallbladder. Laparoscopic cholecystectomy immediately after the diagnosis might result in a good outcome.
