Five Cases of Gallbladder Torsion

Abstract

To clarify clinical characteristics of gallbladder torsion, we retrospectively examined five patients including one man and four wemen, who were operated on for gallbladder torsion in our hospital between 2006 and 2015. The median age was 85 (range 83-92). We were able to diagnose two out of five patients by CT preoperatively, and the remaining three patients underwent surgery because they had bloody bile discharge from their percutaneous transhepatic gallbladder drainage (PTGBD). PTGBD patients included two in whom PTGBD was inserted through the free peritoneal cavity, and their intraoperative findings did not include bile discharge into the peritoneal cavity. All five patients had findings on plain CT, which were significant gallbladder enlargement without gallstone obstruction and high density area in its walls. Three patients had deviation of the cystic duct, and one had a tapered and twisted cystic duct which appeared as a mass. Cholecystectomy was performed under laparotomy in four patients and under laparoscopy in the remaining one. Abdominal CT findings were helpful in confirmation of the diagnosis of gallbladder torsion. PTGBD for gallbladder torsion was performed safely in our cases. It may be useful as a diagnostic tool when diagnostic imaging is difficult.