Laparoscopic treatment of gallbladder volvulus: a pediatric case report and literature review.
Volvulus of the gallbladder has been reported mostly in elderly women and is rarely reported in children. In this paper, we report a recent case of successful detorsion and removal of the gallbladder via minimal access surgery, which was diagnosed as gallbladder volvulus preoperatively by means of magnetic resonance imaging (MRI). An 11-year-old boy presented with an acute abdomen, and acute cholecystitis was suspected, based on the findings of ultrasound and computed tomography. However, a diagnosis of gallbladder volvulus was established through MRI, and emergency laparoscopic surgery was subsequently performed. Laparoscopy revealed a hemorrhagic, gangrenous gallbladder that floated anteriorly. The gallbladder was rotated twice around its pedicle in a counterclockwise direction. It was untwisted through laparoscopy, and a cholecystectomy was performed without difficulty. To achieve an early, prompt preoperative diagnosis, MRI could be an effective alternative to conventional imaging modalities. The advent of laparoscopic detorsion and cholecystectomy as a treatment for gallbladder volvulus allows less invasive treatment, a shorter hospital stay, and better cosmesis, which are highly desirable in children.
Kimura
Takuya
T
Department of Pediatric Surgery, Nara Hospital, Kinki University School of Medicine, Nara, Japan. kimutaku@pedsurg.med.osaka-u.ac.jp
Yonekura
Takeo
T
Yamauchi
Katsuji
K
Kosumi
Takuya
T
Sasaki
Takashi
T
Kamiyama
Masafumi
M
D002648:Child; D002764:Cholecystitis / Q000175:diagnosis; D003937:Diagnosis, Differential; D005705:Gallbladder Diseases / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D014102:Torsion Abnormality / Q000175:diagnosis / Q000601:surgery*