Torsion of the gallbladder: a case report

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Gallbladder torsion is an uncommon surgical emergency, primarily affecting elderly individuals.
• Pre-operative diagnosis is challenging, increasing the risk of complications like gallbladder rupture and biliary peritonitis.

Purpose of the Study:

• To highlight the diagnostic challenges and management of gallbladder torsion.
• To emphasize the importance of considering gallbladder torsion in elderly patients with unexplained abdominal pain.

Main Methods:

• Case presentation of an 80-year-old woman with symptoms initially suggestive of acute cholecystitis.
• Utilized ultrasound and CT scans, which did not reveal gallstones.
• Performed an open cholecystectomy due to persistent symptoms and lack of improvement with conservative management.

Main Results:

• Intraoperative findings confirmed complete gallbladder torsion with gangrenous changes.
• The patient recovered well following the cholecystectomy.
• The case underscores the difficulty in pre-operative diagnosis despite advanced imaging.

Conclusions:

• Gallbladder torsion requires high clinical suspicion in elderly patients presenting with acute abdominal pain, particularly when gallstones are absent and conservative treatment fails.
• Early surgical intervention (cholecystectomy) is essential to prevent life-threatening complications such as biliary peritonitis.