2018 Volume 38 Issue 5 Pages 845-848
An 80-year-old woman complaining of abdominal pain was admitted to our hospital. Physical examination revealed a tender, fist-sized, movable mass in the right lower quadrant of the abdomen. Blood tests revealed elevated levels of inflammatory markers. Abdominal ultrasound and computed tomography showed an enlarged gallbladder with no continuity between the gallbladder neck and the cystic duct, and an elevated tumor was detected inside the gallbladder. Emergency surgery was performed under a preoperative diagnosis of gallbladder torsion and gallbladder tumor. Intraoperatively, we observed gallbladder torsion, with the gallbladder showing an approximately 270° clockwise rotation around its neck. The torsion was carefully fixed, and open cholecystectomy was performed. Macroscopic findings of the resected specimen were necrotic changes associated with ischemia in the gallbladder mucosa and a 30-mm tumor lesion, and histopathology revealed a papillary growth pattern of the tumor. The postoperative histological diagnosis was pStage I gallbladder cancer. Herein, we report a case of gallbladder torsion associated with gallbladder cancer encountered by us. In the diagnosis and treatment of gallbladder torsion suspected as being secondary to gallbladder cancer, the possibility of other complications such as gallbladder necrosis and biliary and carcinomatous peritonitis due to perforation must also be considered.
