Gallbladder volvulus: Difference between revisions

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Overview
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Epidemiology and Demographics
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Latest revision as of 20:04, 6 March 2013

For patient information, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

Synonyms and keywords: Torsion of gallbladder

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Gallbladder Volvulus from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

Treatment

Case Studies

Case #1

Template:WH Template:WS

@@ Line 1: / Line 1: @@
 __NOTOC__
-{{SI}}
+{{Gallbladder volvulus}}
+'''For patient information, click [[Gallbladder volvulus (patient information)|here]]'''
 {{CMG}}; {{AE}} {{ADI}}
-{{SK}} Torsion of gallbladder;
+{{SK}} Torsion of gallbladder
-==Overview==
-Volvulus is twisting of a non solid organ around its mesentric axis. Gallbladder volvullus is  twisting or rotation of gall bladder along the axis of cystic duct and vascular pedicle(cystic artery).<ref>http://www.ncbi.nlm.nih.gov/pubmed?term=17860545</ref>
-==Historical Perspective==
+==[[Gallbladder volvulus overview|Overview]]==
-It was first described by Wendal in 1898.<ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1426674/pdf/annsurg01079-0072.pdf</ref>
-==Pathophysiology==
-Torsion of gall bladder leads to occlusion of cystic duct and artery. This torsion can be complete (180<sup>o</sup> - 360<sup>o</sup>) or incomplete(< 180<sup>o</sup>). Incomplete torsion causes obstruction to bile duct and vascular supply may be spared. In complete obstruction both are compromised.<ref>http://www.annals.edu.sg/pdf/36VolNo8Aug2007/V36N8p705.pdf</ref> This occlusion leads to increase in bile in the lumen and decreased flow of blood to the organ. Increased pressure in the lumen with ischemia leads to acute inflammation causing surgical emergency.
-===Gross Pathology===
-* Enlarged and distended gallbladder.
-* Torsion along the long axis of the peduncle.
-* Thick edematous wall with mucosal congestion.
-===Microscopic Pathology===
-* Extensive necrosis of the wall
-* Findings may be similar to gangrenous cholecystitis due to severe ischemia.
-==Causes==
+==[[Gallbladder volvulus historical perspective|Historical Perspective]]==
-Volvulus of gallbladder is known to be caused due to<ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2784509/</ref>
-* Inherent causes
-** Floating gallbladder
-* Acquired causes
-** Splanchnoptosis
-** Senile humpback
-* Physical causes
-** Sudden changes of intraperitoneal pressure
-** Sudden changes of body position
-** Hyperperistalsis of organs near the gallbladder
-** Defecation
-** Trauma to the abdomen
-==Epidemiology and Demographics==
+==[[Gallbladder volvulus pathophysiology|Pathophysiology]]==
-Over 500 cases have been documented since its description in 1898.<ref>http://www.wjes.org/content/3/1/9</ref>
-===Age===
-* Few cases are reported in pediatric population.
-* 85% of the cases are reported in 60 - 80 age group.
-===Gender===
-* There is a female preponderance for this condition.<ref>http://www.turkgastro.org/text.php?id=515</ref>
-* Female to male ratio is 3:1. <ref>http://www.ncbi.nlm.nih.gov/pubmed?term=6823944</ref>
-==Risk Factors==
+==[[Gallbladder volvulus causes|Causes]]==
-Risk factors for gallbladder volvulus include<ref>http://www.ncbi.nlm.nih.gov/pubmed?term=2229215</ref>
-* Hyperperistalsis
-* Scoliosis
-* Weight loss
-* Multiparity
-Cholelithiasis as a risk factor is still uncertain.
+==[[Gallbladder volvulus differential diagnosis|Differentiating Gallbladder Volvulus from other Diseases]]==
-==Natural History, Complications and Prognosis==
+==[[Gallbladder volvulus epidemiology and demographics|Epidemiology and Demographics]]==
-===Complications===
-* Acute perforation
-* Bilious peritonitis
-* Bowel adhesion's
-* Gallbladder necrosis
-* Gangrenous cholecystitis
-* Sepsis
-===Prognosis===
+==[[Gallbladder volvulus risk factors|Risk Factors]]==
-* It has favorable a prognosis due to early diagnosis and prompt treatment.
-* With immediate surgery the mortality rate is less than 5%. <ref>http://www.ncbi.nlm.nih.gov/pubmed?term=17767346</ref>
-== Diagnosis ==
-Presentation of gallbladder volvulus is very non -specific. It is tough to diagnose based upon history and symptoms alone as  patients presents with acute pain abdomen with or without vomiting. At times there may be a  tender mobile mass palpated suggestive of  floating gallbladder.
-Lau et al grouped clinical features into three triads
+==[[Gallbladder volvulus natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
-* Triad of patient characteristics
-** Thin patient
-** Old patient with chronic chest disease
-** Patient with deformed spine
-* Triad of symptoms
-** Typical abdominal pain
-** Early onset of vomiting
-** A  short history of symptoms
-* Triad of physical signs
-** An abdominal mass,
-**  Lack of toxaemia or jaundice
-** A discrepancy in the pulse and temperature.
+==Diagnosis==
+[[Gallbladder volvulus history and symptoms|History and Symptoms]] | [[Gallbladder volvulus physical examination|Physical Examination]] | [[Gallbladder volvulus laboratory findings|Laboratory Findings]] | [[Gallbladder volvulus CT|CT]] | [[Gallbladder volvulus MRI|MRI]] | [[Gallbladder volvulus ultrasound|Ultrasound]] | [[Gallbladder volvulus other imaging findings|Other Imaging Findings]] | [[Gallbladder volvulus other diagnostic studies|Other Diagnostic Studies]]
-====Skin====
+==Treatment==
-====Head====
+[[Gallbladder volvulus medical therapy|Medical Therapy]] | [[Gallbladder volvulus surgery|Surgery]] | [[Gallbladder volvulus primary prevention|Primary Prevention]] | [[Gallbladder volvulus secondary prevention|Secondary Prevention]] | [[Gallbladder volvulus cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Gallbladder volvulus future or investigational therapies|Future or Investigational Therapies]]
-==== Eyes ====
+==Case Studies==
+[[Gallbladder volvulus case study one|Case #1]]
-==== Ear ====
+[[Category:Emergency medicine]]
+[[Category:Anatomy]]
+[[Category:Gastroenterology]]
+[[Category:Disease]]
-====Nose====
-====Throat ====
-==== Heart ====
-==== Lungs ====
-==== Abdomen ====
-==== Extremities ====
-==== Neurologic ====
-====Genitals====
-==== Other ====
-=== Laboratory Findings ===
-==== Electrolyte and Biomarker Studies ====
-==== Electrocardiogram ====
-==== Chest X Ray ====
-====CT ====
-==== MRI ====
-==== Echocardiography or Ultrasound ====
-==== Other Imaging Findings ====
-=== Other Diagnostic Studies ===
-==References==
-{{reflist|2}}
 {{WH}}
 {{WS}}
-[[Category:Emergency medicine]]
-[[Category:Anatomy]]
-[[Category:Gastroenterology]]

Gallbladder volvulus: Difference between revisions

Latest revision as of 20:04, 6 March 2013

Diagnosis

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