Twists and Turns: Gallbladder Volvulus in an Elderly Patient

Area of Science:

• Gastroenterology
• Abdominal Surgery
• Medical Diagnostics

Background:

• Gallbladder volvulus (GBV) is an uncommon condition involving gallbladder torsion.
• It predominantly affects elderly, thin women and mimics acute cholecystitis.
• Timely diagnosis and treatment are vital to avert ischemic complications.

Observation:

• A 94-year-old woman presented with epigastric and right upper quadrant pain, nausea, and vomiting.
• Laboratory and radiographic findings were non-specific.
• Gallbladder volvulus was diagnosed intraoperatively.

Findings:

• The case highlights the diagnostic difficulty of GBV due to overlapping symptoms with common abdominal pathologies.
• Non-specific clinical presentation and unremarkable initial investigations complicate preoperative diagnosis.
• Intraoperative findings confirmed gallbladder volvulus.

Implications:

• Clinicians should consider GBV in the differential diagnosis of acute abdominal pain, especially in elderly patients.
• Advanced imaging or a high index of suspicion may be necessary for prompt diagnosis.
• Successful management relies on early surgical intervention to prevent gallbladder necrosis and sepsis.