Gallbladder Volvulus in an Elderly Female With Severe Kyphoscoliosis

Gallbladder volvulus is a very rare complication of a congenital defect in gallbladder development also known as a "floating" gallbladder and often presents in the elderly. Proposed aetiologies include loss of abdominal fat and kyphoscoliosis. We present a patient with severe lumbar scoliosis centred on L2, producing a lumbar vertebral distortion of about 30 degrees concave to the right, resulting in right hemiabdomen volume loss. The mechanical interaction between the gallbladder fundus and compressed viscera transmits abnormal ambulatory forces from the distorted right pelvic brim into the abdomen predisposing to gallbladder torsion. Laparoscopic cholecystectomy was performed without complication and the patient had an uneventful recovery. This case demonstrates the challenges of diagnosing gallbladder torsion preoperatively. A high level of clinical suspicion is vital especially in elderly patients to enable timely surgical intervention to reduce morbidity and mortality.