A Case of Gallbladder Torsion Operated on Without Preoperative Diagnosis

Abstract

A 97-year-old man presented to our hospital with a one-day history of abdominal pain. Based on the findings of abdominal CT and MRI, we diagnosed the patient as having acute cholecystitis. Laparoscopic cholecystectomy was performed on the following day, and Gross type I torsion of the gallbladder was diagnosed intraoperatively. The patient had gangrenous cholecystitis, but there was no perforation, and the postoperative course was favorable. Gallbladder torsion is a relatively rare disease that requires prompt diagnosis. We reviewed the clinical findings of one case reported by us, together with those of the previous 53 cases reported during the last 10 years. We compared the past and current correct preoperative diagnosis rates, and concluded that the characteristic imaging findings of gallbladder torsion are important to make a preoperative diagnosis. However, even in cases of acute cholecystitis with no characteristic imaging findings of gallbladder torsion, the possibility of gallbladder torsion and surgery should be considered.