Torsion of the gallbladder is an uncommon disorder which requires prompt surgical treatment because of high incidence of the gangrene. approximately 300 cases have been reported in English literature since the first description by Wendel in 1898
and
only one cases in Korea.
This condition appears more common in women with the peak incidence between 60 and 80 year of age. The symptoms depend on the types of torsion; incomplete (rotation less than 180°) or complete (more than 180°), but correct preoperative
diagnosis
is
rarely made. If it is treated early with choleystectomy, the mortality is low(3~5).
We have experienced one case of complete torsion of the gallbladder in 86 year old woman. The preoperative diagnosis was acute appendicitis with perforation.
At the operation, the gallbladder which was suspended by only thin cystic duct mesentery was rotate 180°counterclockwisely on the axis of cystic artery and cystic duct mesentery and enlarged, measuring 8×8×9 cm. The wall of the gallbladder was
edematous, black-violet in corlor, and the content was mixtures of bile and old blood, suggesting hemorrhagic infarction. The common bile duct is dilated about 2 cm in diameter and is Clonorchis sinensis infestated. After detorsion, chocystectomy
with
T-tube choledochostomy was performed. The patient recovered uneventfully except mild degree of paralytic lieus and discharged 17th day after operation.
We herein report one case of acute torsion of the gallbladder with review of the previous literatures.
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