Abstract
A variety of diseases can cause acute abdomen. We have experienced gallbladder torsion which is a rare entity as a disease causing acute abdomen in an aged patient and have gained a favorable therapeutic outcome by making early preoperative diagnosis.
An 88-year-old woman was admitted to our hospital because of abdominal pain. We diagnosed the patient as having gallbladder torsion by contrast-enhanced computed tomography (CT) and ultrasonography (US) findings. Abdominal CT scan showed an enlarged gallbladder and lack of the wall enhancement. US showed a square shaped gallbladder and thickening of the gallbladder wall, and color Doppler signals indicated lack of blood supply. We performed emergency operation, and cholecystectomy by open laparotomy was done. The gallbladder was twisted clockwise by over 180 degrees at the neck of the gallbladder. The gallbladder was supported by the mesentery around the cystic duct only. Thus gallbladder torsion Gross typeII was diagnosed. No complications occurred after the operation. Ten days after the operation, she was discharged from the hospital in a good physical condition.
Gallbladder torsion has similar symptoms to those of acute cholecystitis, so that it is difficult to diagnose it preoperatively. In this case, early diagnosis and selection of cholecystectomy by open laparotomy might lead to a good outcome.
