Gallbladder colonic hepatic flexure adhesion syndrome

  Cholecysto-hepatic Flexure Adhesion Syndrome was first described by Verbryche in 1930. Therefore, it is also called Verbrycke’s syndrome and Cholecysto-hepatic Flexure Adhesion Syndrome.  Diagnosis】Cholangiogram: The gallbladder function is normal, but the gas shadow of the hepatic flexure of the large intestine can be seen connected with or adjacent to the bottom of the gallbladder, and if barium colonography is performed at the same time, it can show the lesion site. It is not difficult to make a diagnosis based on clinical symptoms and cholangiography.  If symptomatic treatment is ineffective, the gallbladder can be removed if the gallbladder lesion is present, and if the gallbladder is normal, release surgery is feasible.  Etiology】 This syndrome is caused by the adhesion between the bottom of the gallbladder and the hepatic flexure of the large intestine, which makes the large intestine form an acute angle and makes it difficult for the intestinal contents to pass through, resulting in the pneumatization of the hepatic flexure of the large intestine. Although the gallbladder can be filled, concentrated and emptied normally, when the large intestine produces gravitational traction on the gallbladder, it can cause a series of clinical symptoms.  Clinical manifestations] The clinical manifestations are dull pain in the upper abdomen or right upper abdomen when standing upright, nausea, loss of appetite and other symptoms; generally occurring during the daytime, with symptoms worsening after prolonged standing, pressure pain in the right upper abdomen, and mild protective muscle ankylosis.  Differential diagnosis】 Differential diagnosis should be made with chronic cholecystitis, colorectal hepatic flexure syndrome, cholelithiasis, etc.