Syed Muhammad Ali
Hamad Medical Corporation | Qatar
Title: Gallbladder volvulus with segmental right liver lobe hypoplasia/atrophy: A preoperative diagnostic dilemma
Biography
Biography: Syed Muhammad Ali
Abstract
Gallbladder Volvulus with segmental right liver lobe hypoplasia/atrophy: A preoperative diagnostic dilemma
Gallbladder Volvulus (GBV) due to rotation of the gallbladder (GB) around its own mesentery, is 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 posterior segment of right liver lobe and a GB with no hepatic attachments but only mesenteric pedicle; an anatomical variant combination which has not been classified before. 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. Histopathologic examination showed intramural hematoma of GB with wall necrosis.