Question:

Which of the following answer choice(s) regarding the diagnosis and pathophysiology of gallbladder torsion is true?
1. Symptoms may be intermittent.
2. It is usually diagnosed preoperatively.
3. Gallstones are present in the vast majority of cases.
4. Gallbladder torsion results in gallbladder ischemia and mural necrosis.
5. Complete torsion refers to a twist of greater than 360 degrees.





Answer:

The correct answers for the question "Which of the following answer choice(s) regarding the diagnosis and pathophysiology of gallbladder torsion is true?" are:

1. Symptoms may be intermittent.

4. Gallbladder torsion results in gallbladder ischemia and mural necrosis.



Explanation
1. Symptoms of gallbladder torsion may be intermittent. [Symptoms may be intermittent secondary to torsion-detorsion phenomenon.]

2. Gallbladder torsion is usually diagnosed at the time of surgery. [Gallbladder torsion is diagnosed preoperatively only 10% of the time.]

3. Gallstones are not always present in the setting of gallbladder torsion. [Interestingly, gallstones are present in only 60% of cases, a smaller percentage than in typical acute cholecystitis.]

4. Gallbladder ischemia and mural necrosis is a result of the vascular compromise produced by gallbladder torsion. [Torsion of the gallbladder neck typically results in vascular compromise with ischemia and mural necrosis.]

5. Complete torsion refers to a twist of greater than 180 degrees. [Incomplete torsion occurs when the twist is less than 180 degrees; greater than 180 degrees of twisting is considered complete torsion.]



From the manuscript:
Gallbladder torsion resulting in gangrenous cholecystitis within a parastomal hernia: Findings on unenhanced CT
Radiology Case. 2013 Dec; 7(12):21-25


This article belongs to the GI section.




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From the manuscript

Gallbladder torsion resulting in gangrenous cholecystitis within a parastomal hernia: Findings on unenhanced CT

Free full text article: Gallbladder torsion resulting in gangrenous cholecystitis within a parastomal hernia:  Findings on unenhanced CT

Abstract
Gallbladder torsion is a rare cause of acute gangrenous cholecystitis; its occurrence within an abdominal hernia has not been previously reported. We present such a case occurring within a parastomal hernia and imaged with unenhanced CT.






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