Torsion of the Gallbladder

Lee, Chul Hee; Cho, Hyun Min; Suh, Young Jin; Won, Yong Sung; Chin, Hyung Min; Kim, Jun Gi; Park, Woo Bae; Chun, Chung Soo

Abstract

Torsion of the gallbladder is a relatively rare disease and is generally due to abnormal anatomical fixation of the gallbladder. It occurs when the gallbladder twists axially, with subsequent occlusion of bile or blood flow that requires prompt surgical treatment. We report here a case of torsion of the gallbladder in a 75-year-old man with right upper quadrant abdominal pain and heart failure. Ultrasonography and computed tomography demonstrated a distended gallbladder that contained no stones. Since the symptoms did not respond to antibiotics, a cholecystectomy was performed. We found the gallbladder to be twisted around its pedicle and the patient had an uneventful postoperative course. Gallbladder torsion should be treated early particularly in high risk patient. Since its first description a century ago, the diagnosis of gallbladder torsion prior to operative exploration has been extremely elusive. However, there are typical clinical and radiological findings consistent with torsion of the gallbladder that should raise the index of suspicion for this condition preoperatively. We present a case of gallbladder torsion and discuss the pertinent literature concerning the salient clinical features and diagnostic tests.