Abstract
80-year-old female presented with clinical findings suggestive of acute cholecystitis. Intraoperatively we discovered a dusky gallbladder with gangrenous patches and gallbladder torsion with 270 degrees clockwise rotation along the longitudinal axis. Gallbladder torsion is a rare cause of acute cholecystitis with less than 500 cases published in the literature. Gallbladder torsion should be included in the list of differential diagnoses in patients suspected of having acute cholecystitis especially when there are inconsistencies between clinical features and imaging. It is worth noting that 3-dimensional reconstructed CT may be useful in preoperative diagnosis of gallbladder torsion.
Highlights
Gallbladder torsion is a rare presentation of gallbladder pathology
Acalculous cholecystitis is related to poor perfusion of the gallbladder, acute inflammation with necrosis, bile stasis, bacterial overgrowth and secondary infection
This case demonstrated that gallbladder torsion is another possible mechanism for acute gangrenous cholecystitis which is rarely suspected pre-operatively, yet
Summary
Gallbladder torsion is a rare presentation of gallbladder pathology. Features are generally consistent with acute cholecystitis and the diagnosis is usually made intraoperatively. Further research is needed to assess the benefits of imaging modalities preoperatively, 3-dimensional CT reconstruction in gallbladder pathology. If gallbladder torsion is suspected or diagnosed, prompt surgical intervention is required
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