儿童胆囊扭转病例1例报道及文献复习

A Case Report of Torsion of the Gallbladder in Pediatric Population and Literature Review

目的:收集胆囊扭转病例资料,总结相关临床、辅助检查结果,提高术前诊断准确性。方法:报道1例儿童胆囊扭转病例,回顾性分析其临床表现、辅助检查图像资料、手术过程,并复习相关文献。结果:胆囊扭转多发生于老年女性,儿童发病率极低,病程短,胆囊区疼痛明显,可伴有呕吐症状,无发热、黄疸。B超下胆囊可见“8”字改变,交叉部高回声。磁共振胰胆管造影(MRCP)可观察到胆囊影中断或胆囊管呈尖状。CT极少数可能看到胆囊螺旋形改变。结论:儿童中胆囊扭转罕见,症状易混淆,B超、MRCP具有重要术前诊断价值。

Objective: To collect gallbladder torsion case data, summarize relevant clinical and auxiliary examination results, and improve the accuracy of preoperative diagnosis. Methods: A case of gallbladder torsion in children was reported. The clinical manifestations, auxiliary examination images, surgical procedures, and related literature were reviewed retrospectively. Results: Gallbladder torsion occurs mostly in elderly women. The incidence of children is extremely low. The course of disease is short, and the pain in the gallbladder area is obvious. It may be accompanied by vomiting symptoms, no fever or jaundice. Under the B-ultrasound, the "8" shape can be seen in the gallbladder, and the echo at the intersection is high. MRCP can be observed to interrupt the gallbladder or the cystic duct is pointed. Very few CTs may see a spiral change in the gallbladder. Conclusion: In children, gallbladder torsion is rare, symptoms are confusing, and B-ultrasound and MRCP have important preoperative diagnostic value.