Presentation of gallbladder torsion at an abnormal position: A case report

Area of Science:

• Medical imaging
• Surgical emergencies
• Gastroenterology

Background:

• Gallbladder torsion is an uncommon cause of acute abdominal pain, often affecting elderly women.
• Diagnosis is frequently delayed due to non-specific clinical and imaging findings.
• Prompt surgical intervention, such as cholecystectomy, is crucial to prevent complications like perforation.

Observation:

• A case study involving an 82-year-old woman presented with symptoms mimicking acute cholecystitis.
• Magnetic Resonance Cholangiopancreatography (MRCP) revealed characteristic "twisting signs": V-shaped distortion of bile ducts and an elongated, twisted cystic duct.
• These findings strongly suggested gallbladder torsion, leading to emergency laparoscopic cholecystectomy.

Findings:

• MRCP is a valuable tool for the pre-operative diagnosis of gallbladder torsion.
• Specific "twisting signs" observed on MRCP, including V-shaped bile duct distortion and cystic duct elongation, are indicative of torsion.
• Laparoscopic cholecystectomy confirmed the diagnosis and resulted in a successful patient recovery.

Implications:

• Early and accurate diagnosis of gallbladder torsion via MRCP can significantly improve patient outcomes.
• Recognition of "twisting signs" on MRCP facilitates timely surgical management, reducing morbidity and mortality.
• This diagnostic approach enhances the management of rare surgical abdominal conditions.