A twisted gallbladder hid behind a picture of acute cholecystitis
An octogenarian's apparent acalculous cholecystitis turned out to be gallbladder volvulus, caught only when the CT images were reviewed again.
A woman in her 80s came to the emergency department with abdominal pain and vomiting, after three days of intermittent colicky pain. Her gallbladder was palpable and extremely tender in the upper middle abdomen. Cross-sectional imaging suggested acute acalculous cholecystitis with marked distension and possible perforation.
On a second look at the images, a clinician suspected the gallbladder had twisted on its axis. That suspicion made the operation an emergency. At laparoscopy, the gallbladder was grossly distended and necrotic, confirming volvulus. The surgeons untwisted it, returned it to its normal position, and then performed a routine laparoscopic cholecystectomy.
This is a single case report, so it cannot show how often the condition occurs or how reliably imaging reveals it. The authors suggest considering torsion in elderly patients without known gallstones who have colicky pain and suggestive imaging features.
Summary prepared with AI assistance from the published abstract and reviewed by a physician. Not medical advice. Learn more
