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Torsion of the gallbladder in a 3-year-old infant

  • Case report of interest
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Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

A 3-year-old girl was admitted to hospital with complaints of severe upper abdominal pain and vomiting. On admission, a board-like rigidity in the right hypochondrium was noted, along with a high white blood cell count and a high C-reactive protein value. Abdominal ultrasonography (US) revealed a left-sided enlarged gallbladder with a thickened wall, without gallstones. Contrast-enhanced computed tomography (CT) demonstrated an enlarged gallbladder without enhancement effects and a cystic duct located on the right side of the gallbladder. The patient underwent an emergency operation following a diagnosis of torsion of the gallbladder. The gallbladder appeared gangrenous, and 180° clockwise torsion was found at the neck of the gallbladder. The gallbladder was straightened and then removed without difficulty because there was only slight inflammation around Calot’s triangle and the gallbladder was not fixed to the liver. Histopathological examination revealed an acute bleeding infarction of the gallbladder. The patient was discharged on the ninth day after surgery, without any complications. The present case suggested that abdominal US and contrast-enhanced CT examinations are helpful in making a correct diagnosis of torsion of the gallbladder even in an infant; in the event of this diagnosis, prompt cholecystectomy is necessary.

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Authors and Affiliations

  1. Department of Surgery, National Hospital Organization Saga Hospital, Saga, Japan

    Takayuki Hamada, Junzo Yamaguchi, Takashi Ueda & Kunihide Izawa

  2. Department of Pathology, National Hospital Organization Saga Hospital, Saga, Japan

    Hiroshi Ohtani & Isao Shimokawa

  3. Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Takayuki Hamada, Yoshitsugu Tajima & Takashi Kanematsu

Authors
  1. Takayuki Hamada
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  2. Yoshitsugu Tajima
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  3. Junzo Yamaguchi
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  4. Takashi Ueda
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  5. Kunihide Izawa
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  6. Hiroshi Ohtani
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  7. Isao Shimokawa
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  8. Takashi Kanematsu
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Correspondence to Takayuki Hamada.

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Hamada, T., Tajima, Y., Yamaguchi, J. et al. Torsion of the gallbladder in a 3-year-old infant. J Hepatobiliary Pancreat Surg 16, 234–237 (2009). https://doi.org/10.1007/s00534-008-0027-9

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  • DOI: https://doi.org/10.1007/s00534-008-0027-9

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