急腹症中的罕见病-胆囊扭转12例的诊治体会

Diagnosis and Treatment of a Rare Disease-gallbladder Volvulus among Acute Abdominal Diseases: a Report of 12 Cases

目的探讨急腹症中的罕见病胆囊扭转的临床表现,早期诊断与治疗。方法回顾性分析本院1998年2月至2010年12月经手术证实12例胆囊扭转的临床资料。结果 7例胆囊扭转患者胆囊切除术后治愈出院,另5例中3例患者行胆囊造瘘术病情缓解二期再手术治愈,2例患者术后因多器官衰竭死亡。所有12例患者术前均误诊,误诊率100%。结论胆囊扭转无特殊的临床表现,术前确诊困难,早期手术治疗预后较好,术式以开腹胆囊切除术为好。

Objective To discuss the clinical features and early diagnosis and treatment of a rare disease-gallbladder volvulus among acute abdominal diseases. Method Retrospective analysis with clinical data about gallbladder volvulus made a definite diagnosis by operation from February 1998 to December 2010. Results 7 cases were cured after cholecystectomy, 3 cases were cured by second operation after gallbladder fistulation again and remainder 2 cases died from multiple organ failure postoperative gallbladder fistulation. All the 12 cases were made error diagnosis before operation and roughly 100% incidence. Conclusion Owing to nonspecifie feature, the diagnosis of gallbladder volvulus is very difficult to make. The better prognosis depends on early operation and suitable operation pattern-open laparocholecystectomy.