Printed Journal | Refereed Journal | Peer Reviewed Journal
Peer Reviewed Journal
2025, Vol. 7, Issue 2, Part B
Gallbladder volvulus: A case report of an elderly female presenting with acute cholecystitis
Author(s): Samuel Baule, Katherine Powell, Robert Dorenbusch and Viney Mathavan
Abstract:
Gallbladder volvulus (GBV) is a rare and acute condition resulting from the twisting of the gallbladder around its mesentery. Often mistaken for acute calculous cholecystitis, GBV presents diagnostic challenges due to nonspecific clinical and imaging findings. Preoperative diagnosis is uncommon, with most cases identified intraoperatively.
We report the case of a 90-year-old female from a memory care facility who presented with progressive abdominal pain and nausea. Physical examination revealed significant right upper quadrant tenderness with a positive Murphy's sign. Laboratory findings included leukocytosis and mild transaminase elevation. Imaging demonstrated a distended gallbladder with cholelithiasis and wall thickening. The patient underwent laparoscopic cholecystectomy, during which GBV with ischemic and necrotic changes of the gallbladder was identified. Surgical management included decompression followed by subtotal cholecystectomy. The patient successfully recovered with minor postoperative complications.
GBV is estimated to occur in approximately 1 in 365 000 cases of gallbladder disease, with certain anatomical variations, such as a freely mobile gallbladder, predisposing to its development. Definitive preoperative diagnosis remains challenging due to overlapping clinical and radiographic features with acute calculous cholecystitis. However, previous literature has suggested certain patient populations are more susceptible to GBV, specifically elderly females with thin body habitus and scoliosis. Although imaging modalities such as MRCP and PET scans may raise suspicion, intraoperative findings remain the gold standard for diagnosis. This case aligns with established diagnostic patterns, including patient demographics and clinical presentation, and underscores the limitations of current diagnostic approaches.
GBV should remain a differential consideration in thin elderly patients with spinal deformities presenting with acute abdominal pain and imaging findings consistent with acute calculous cholecystitis. Early surgical intervention based on clinical suspicion is crucial to reduce associated morbidity and mortality.
DOI: 10.22271/27081494.2025.v7.i2b.201
Pages: 63-66 | Views: 256 | Downloads: 121
Download Full Article: Click Here
How to cite this article:
Samuel Baule, Katherine Powell, Robert Dorenbusch, Viney Mathavan. Gallbladder volvulus: A case report of an elderly female presenting with acute cholecystitis. Int J Case Rep Surg 2025;7(2):63-66. DOI: 10.22271/27081494.2025.v7.i2b.201
Related Links
Related Journal Subscription
International Journal of Case Reports in Surgery
This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author. This is in accordance with the Budapest Open Access Initiative (BOAI) definition of open access.
The articles in International Journal of Case Reports in Surgery are open access articles licensed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc-sa/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
Copyright © 2025. International Journal of Case Reports in Surgery All Rights Reserved. Subject to change without notice from or liability to International Journal of Case Reports in Surgery.
Contact Information
Any correspondence, queries or additional requests for information on the manuscript submission process should be sent to the International Journal of Case Reports in Surgery editorial office as follows:
Address: 1st Floor, Block C, Metropolitan Park, 8 Hillside Road, Parktown, Johannesburg, 2196, South Africa
Email: casereportsofsurgery@gmail.com
