Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2013 Spring;17(2):80-3.
doi: 10.7812/TPP/12-118.

A Clinician's Guide to the Diagnosis and Management of Gallbladder Volvulus

Brian J Pottorf  1 , Leonardo Alfaro, Harris W Hollis
Affiliations
Review

A Clinician's Guide to the Diagnosis and Management of Gallbladder Volvulus

Brian J Pottorf et al. Perm J. 2013 Spring.

Abstract

Introduction: Gallbladder volvulus (GV), or torsion of the gallbladder, is an uncommon surgical emergency. This article reviews the world literature related to GV. We examine the history of gallbladder torsion and highlight the critical constellation of presenting signs and symptoms, which guide the acute care physician and surgeon to accurate and timely diagnosis of GV before surgical intervention.

Methods: A comprehensive review of all published cases of GV was performed using the National Library of Medicine (PubMed) database.

Results: Lists of typical symptoms and clinical presentations are provided to allow clinicians to establish an accurate preoperative diagnosis.

Conclusion: GV is frequently undiagnosed before surgical intervention. However, clinical presentation and associated radiographic findings can lead to an accurate diagnosis if the clinician is aware of this uncommon condition. When the diagnosis has been established before operative intervention, expeditious laparoscopic cholecystectomy can be performed safely. Delays in diagnosis may mandate open cholecystectomy if laparoscopic extraction is contraindicated because of undesirable sequelae of gallbladder necrosis, specifically perforation, bilious peritonitis, and hemodynamic instability.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Computed tomography scan of the abdomen with contrast, showing a thickened gallbladder wall and pericholecystic inflammation.
Figure 2
Figure 2
Ultrasonogram of the gallbladder revealing pericholecystic fluid (FF).
Figure 3
Figure 3
Clockwise volvulus along the mesenteric pedicle (hollow arrow) with an ischemic body (solid black arrow) displaced near the stomach (hollow arrowhead).
Figure 4
Figure 4
Gallbladder specimen with ischemia distal to the point of transection.
See this image and copyright information in PMC

References

    1. Garciavilla PC, Alvarez JF, Uzqueda GV.Diagnosis and laparoscopic approach to gallbladder torsion and cholelithiasis JSLS 2010January–Mar141147–51.DOI: http://dx.doi.org/10.4293/108680810X12674612765588 - DOI - PMC - PubMed
    1. Wendel AV., VI A case of floating gall-bladder and kidney complicated by cholelithiasis, with perforation of the gall-bladder. Ann Surg. 1898 Feb;27(2):199–202. - PMC - PubMed
    1. Caliskan K, Parlakgumus A, Koc Z, Nursal TZ. Acute torsion of the gallbladder: a case report. Cases J. 2009 Apr 29;2:6641. DOI: http://dx.doi.org/10.1186/1757-1626-0002-0000006641. - DOI - PMC - PubMed
    1. Amrani Y, Ounani M, Beavogui L, et al. [Gallbladder volvulus: two cases]. [Article in French] Presse Med. 2006 Oct;35(10 Pt 1):1479–81. DOI: http://dx.doi.org/10.1016/S0755-4982(06)74838-2. - DOI - PubMed
    1. Cameron EW, Beale TJ, Pearson RH. Case report: torsion of the gall-bladder on ultrasound—differentiation from acalculous cholecystitis. Clin Radiol. 1993 Apr;47(4):285–6. DOI: http://dx.doi.org/10.1016/S0009-9260(05)81142-0. - DOI - PubMed

MeSH terms

LinkOut - more resources