Cholecysto-hepatic Flexure Adhesion Syndrome was first described by Verbryche in 1930. Hence, it is also known as Verbrycke syndrome or gallbladder-hepatic flexure adhesion syndrome.

bubble_chart Etiology

This condition is caused by the adhesion between the fundus of the gallbladder and the hepatic flexure of the large intestine, which forms an acute angle in the large intestine, making it difficult for intestinal contents to pass and leading to gas accumulation in the hepatic flexure of the large intestine. Although the gallbladder can fill, concentrate, and empty normally, when the large intestine exerts gravitational traction on the gallbladder, it can cause a series of clinical symptoms.

bubble_chart Clinical Manifestations

The clinical manifestations include dull pain in the upper abdomen or right upper quadrant when standing upright, nausea, loss of appetite, and other symptoms; these generally occur during the day and worsen after prolonged standing, with tenderness in the right upper quadrant and grade I protective muscle rigidity.

bubble_chart Diagnosis

Cholecystography: The gallbladder function is normal, but gas shadows from the hepatic flexure of the large intestine can be seen connected or adjacent to the fundus of the gallbladder. If a barium enema of the large intestine is performed simultaneously, the lesion site can be visualized. The diagnosis is straightforward based on clinical symptoms and findings from the cholecystography examination.

bubble_chart Treatment Measures

If symptomatic treatment is ineffective, the gallbladder can be removed if there are gallbladder lesions, or a decompression procedure can be performed if the gallbladder is normal.

It should be differentiated from chronic cholecystitis, hepatic flexure syndrome of the large intestine, and cholelithiasis.