Gallbladder volvulus

Vólvulo de la vesícula biliar

Introduction: Gallbladder volvulus is an uncommon cause of acute abdomen, characterized by rotation about its mesentery along the longitudinal axis of the pedicle. A case of gallbladder volvulus is presented.

Case presentation: 71-year-old female patient who consulted for severe, intermittent and sudden pain in the right upper abdominal quadrant accompanied by nausea and vomiting. Abdomen was soft, not distended, slightly painful on deep palpation in the right upper quadrant. Ultrasonography showed distended gallbladder with asymmetric thickening of the walls, without evidence of gallstones. During surgery gallbladder was found to be blackish, markedly distended with areas of gangrene and necrosis, without evidence of perforation and rotated 360º on the longitudinal axis counterclockwise.

Discussion:The main manifestation of gallbladder volvulus is abdominal pain in the right upper quadrant, but its characteristics are variable and can mimic acute cholecystitis, so it can be difficult to identify it preoperatively. Definitive diagnosis is usually made during surgery. Prognosis is usually favorable when the diagnosis is timely.

Conclusion: Gallbladder volvulus is an uncommon surgical emergency that should be suspected in all patients presenting with signs and symptoms of acute cholecystitis. Cholecystectomy is the treatment of choice in these cases, leading to an excellent prognosis.

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