Cholecystitis secondary to gallbladder torsion - A rare case report

INTRODUCTION: Gallbladder torsion is a rare condition of increasing prevalence in recent years. It is often difficult to diagnose pre-operatively and delayed intervention can lead to significant complications. PRESENTATION OF CASE: We present a case of an 81 year old lady who presented with symptoms of cholecystitis for 24 h with no evidence of cholelithiasis on imaging. She deteriorated within 24 h of admission despite intravenous antibiotics; Emergency laparoscopy was performed which showed the gallbladder malrotated 180 degrees with features of necrosis. Laparoscopic cholecystectomy was performed without complications. DISCUSSION: The cause of gallbladder torsion are thought to be due to underlying anatomical variations or loss of elasticity associated with aging. Diagnosis is difficult clinically and radiologically, however, features such as "whirl sign" and "cystic duct knot sign" have been described. Due to ischemia associated with torsion, clinical vigilance and early intervention is recommended to prevent potential fatal sequelae particularly in the elderly population. CONCLUSION: Gallbladder torsion is a rare finding that can be difficult to diagnose clinically, we are hoping to promote awareness to prevent complications associated with delayed therapy. (C) 2018 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.