Gallbladder volvulus: Recognizing the rare 'beak' and 'whirl' signs

Gallbladder volvulus is a rare surgical emergency caused by torsion of the gallbladder on its mesentery, leading to cystic duct and vascular obstruction with rapid progression to ischemia and gangrene, and it often mimics acute acalculous cholecystitis, making preoperative diagnosis challenging. A 80-year-old woman presented with acute right upper quadrant pain and vomiting. Contrast-enhanced CT demonstrated a distended, horizontally displaced gallbladder with gallstones and the "whirl" and "beak" signs consistent with cystic pedicle torsion. Urgent surgery confirmed ischemic volvulus; detorsion with cholecystectomy and intraoperative cholangiography was performed, followed by an uneventful recovery. This case highlights the importance of recognizing specific radiological features to achieve early diagnosis and emphasizes that prompt surgical intervention, preferably laparoscopic, is essential to prevent severe complications and optimize outcomes.