Unexpected intraoperative finding of gallbladder torsion

Abstract

Gallbladder (GB) torsion or volvulus is a rare entity affecting elderly women. Only ~500 cases have been reported in the literature. Incidence is rare seen in ~1 in 365 520. A constant finding is the presence of the GB on a mobile mesentery. Torsion, or volvulus, of the GB occurs when it twists axially, with the subsequent obstruction of bile and/or blood flow. We briefly describe a 75-year-old female patient with acute abdomen and ultrasound and Computed tomography of abdomen revealed a distended GB. On laparotomy, we encountered a twisted GB with gangrene and cholecystectomy was done. GB volvulus is a rare occurrence and clinically mimic’s acute cholecystitis and should be sought with high suspicion especially when encountering a thin elderly woman. Immediate diagnosis is prime as delay may be fatal. Even with recent advances in imaging, it is difficult to make a correct preoperative diagnosis of GB torsion.

Case report: Rare floating gallbladder torsion in a child

“…(2) Acquired anatomical factors: The higher incidence of GT in the elderly is due to the gradual atrophy and reduction of the tissue structure around the gallbladder and the adipose tissue supporting the gallbladder during the aging process, the tissue degeneration and elasticity decrease and the gallbladder dropping makes the mesentery of the gallbladder longer ( 14 , 15 ). In addition, peristalsis of the stomach, duodenum, and transverse colon and external factors such as physical labor and sudden changes in body position may cause GT ( 16 ).…”