Gallbladder Volvulus Masquerading as Acute Cholecystitis: A Case Report.

Gallbladder volvulus is a rare condition that disproportionately affects elderly women. It occurs in patients with aberrant anatomy that results in a hypermobile gallbladder free to twist on the mesentery, leading to ischemia and necrosis. Due to its close resemblance to cholecystitis, it is difficult to diagnose preoperatively, thus most cases are diagnosed intraoperatively. In our case, a 90-year-old female was transferred to the hospital from an outside facility after being diagnosed with acute cholecystitis. A robotic-assisted laparoscopic approach was used to gain entry into the abdomen. Upon entry, the gallbladder was gangrenous, detached from the liver bed, and twisted on the cystic duct. Despite the presence of severe inflammatory changes and adhesions, the gallbladder was resected without complications, and the patient was discharged on postoperative day five.

Retrospective Study of Psychiatric Hospitalizations in a West Texas Mental Health Treatment Facility during the COVID-19 Pandemic.

OBJECTIVES: The association between the coronavirus disease (COVID-19) pandemic and adverse mental health outcomes has been well documented; however, little is known about its impact in rural areas of the United States. This study aims to characterize and compare inpatient psychiatric admissions in West Texas before and during the initial months of the COVID-19 pandemic. METHODS: A retrospective study was conducted using the electronic health records of 1392 inpatient psychiatric admissions from period A (March 13, 2019-July 3, 2019) to period B (March 13, 2020-July 3, 2020). RESULTS: During period B, there was a significant increase in the length of stay (P < 0.01) compared with period A. The pandemic was associated with an increased history of psychiatric medication use (P < 0.01), substance use (P ≤ 0.01), and suicide risk at the time of admission (P < 0.01). Significant differences were found in employment status (P < 0.01), living situation (P < 0.01), and ethnicity (P = 0.03). CONCLUSIONS: Rural communities in West Texas experienced a decrease in psychiatric hospitalizations during the beginning of the COVID-19 pandemic, followed by an increase as lockdown restrictions began to lift; this warrants further investigation into healthcare service utilization during the pandemic.