A Twist in the Tale: A Case Report on the Laparoscopic Management of a Rare Gallbladder Torsion

Gallbladder torsion is a rare but potentially life-threatening surgical emergency that poses a significant diagnostic challenge due to the condition's non-specific clinical presentation and often inconclusive imaging findings. We present the case of a 53-year-old woman with sudden-onset right upper quadrant abdominal pain and unintentional weight loss. Her low body mass index and initial clinical findings suggested acute cholecystitis. Ultrasonography revealed a distended gallbladder without cholelithiasis. Despite conservative management, her symptoms worsened, prompting an emergency diagnostic laparoscopy. Intraoperatively, a 360° clockwise torsion of a completely mobile, ischemic gallbladder was identified. Detorsion followed by laparoscopic cholecystectomy was performed, resulting in an uneventful recovery for the short-term follow-up period of three months. Gallbladder torsion should be considered in middle-aged or elderly patients presenting with atypical features of acute cholecystitis, particularly when imaging is inconclusive and there is a poor response to medical therapy. Early recognition and prompt surgical intervention are essential to prevent serious complications. This case highlights the importance of maintaining a high index of suspicion for rare causes of acute abdomen.