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CASE REPORT
Gallbladder volvulus with segmental right liver lobe hypoplasia/atrophy: a preoperative diagnostic dilemma
  1. Shameel Musthafa1,
  2. Zia Aftab1,
  3. Syed Muhammad Ali1,
  4. Maneesh Khanna2
  1. 1 General Surgery, Hamad General Hospital, Doha, Qatar
  2. 2 Radiology, Hamad General Hospital, Doha, Qatar
  1. Correspondence to Dr Shameel Musthafa, drshameelmusthafa{at}yahoo.com

Summary

Gallbladder volvulus (GBV) due to rotation of the gall bladder (GB) around its own mesentery is a rare surgical emergency and often identified intraoperatively. Typically, cholecystitis is the initial clinical diagnosis, but a high index of suspicion on imaging can alert the physician for the possibility of GBV requiring urgent surgical intervention. We describe a case of a young female patient with hypoplasia/atrophy of the posterior segment of the right liver lobe and a GB with no hepatic attachments but only mesenteric pedicle. She presented with first episode of sudden-onset, severe right subcostal pain. The ultrasonogram and magnetic resonance cholangiopancreatogram findings were suggestive of GBV. She underwent laparoscopic exploration that confirmed GBV of a free-floating GB with a thrombosed cystic artery. The GB was detorted, and cholecystectomy was performed. She had an uneventful postoperative course and was discharged with no complications. Histopathological examination showed intramural haematoma of the GB with wall necrosis.

  • general surgery
  • gestrointestinal surgery
  • pancreas and biliary tract
  • ultrasonography
  • radiology
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Footnotes

  • Contributors SM assisted in performing the procedure, interpreted patient data, collected previously published literature on the subject and contributed to writing the manuscript. SMA was also a contributor in writing the manuscript, as well as providing expert revision. ZA performed the surgical procedure, provided the surgical images and contributed to writing the manuscript. MK reviewed the radiological investigations of the patient, contributed to writing the manuscript and provided images for USG and MRCP.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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