Abstract
An 89-year-old woman was diagnosed as having acute cholecystitis and gallstones. Abdominal computed tomography showed a very swollen gallbladder with pronounced wall-thickening ; however, the gallbladder was not enhanced. Necrotizing cholecystitis caused by torsion of the gallbladder was suspected. Percutaneous drainage of the gallbladder under ultrasonographic guidance was attempted. Unfortunately, only the bloody content of the gallbladder could be aspirated but the drainage tube could not be placed. Given the diagnosis of gallbladder torsion, emergent laparoscopic surgery was performed. A Gross type-II floating gallbladder was found ; it was twisted 270 degrees clockwise along its longitudinal axis. The twisted gallbladder was untwisted and a laparoscopic cholecystectomy was done. Segmental adenomyomatosis was seen in the gallbladder, and many gallstones were located in the distal chamber, which was considered a cause of torsion. The patient was discharged 3 days after surgery. Torsion of the gallbladder is rare, It has been reported mostly in elderly women and these patients require emergent treatment. Laparoscopic cholecystectomy is the most useful treatment option for torsion of the gallbladder.
