Twisted Mystery: Identifying Gallbladder Volvulus: Challenges in Preoperative Diagnosis.

Area of Science:

• Gastroenterology
• Surgical Emergencies
• Radiology

Background:

• Gallbladder volvulus (GV) is a rare surgical emergency caused by gallbladder torsion.
• It often mimics acute cholecystitis, posing diagnostic challenges, especially in elderly patients.
• Excessive gallbladder mobility is a predisposing factor.

Purpose of the Study:

• To report a case of gallbladder volvulus in an 85-year-old woman.
• To emphasize the importance of considering GV in the differential diagnosis of abdominal pain.
• To illustrate diagnostic and management strategies for this rare condition.

Main Methods:

• Case report of an 85-year-old female presenting with abdominal pain.
• Initial ultrasound and CT scans were suggestive but not definitive.
• Radiological signs, including the "whirl sign," raised suspicion for GV.
• Laparoscopic exploration confirmed 360° gallbladder torsion.

Main Results:

• Laparoscopic cholecystectomy was performed successfully without complications.
• The patient experienced an uneventful recovery.
• The case demonstrates successful recognition and management of GV.

Conclusions:

• Gallbladder volvulus should be considered in the differential diagnosis of abdominal pain, particularly in the elderly.
• Comprehensive clinical assessment and advanced radiological diagnostics are vital for early detection.
• Timely intervention, such as laparoscopic cholecystectomy, leads to favorable outcomes.