The Journal of Emergency Medicine
Volume 30, Issue 4 , Pages 397-401, May 2006

Torsion of the gallbladder: A rare cause of acute cholecystitis

  • David M. Lemonick, MD

      Affiliations

    • Department of Emergency Medicine, The Western Pennsylvania Hospital, 4800 Friendship Avenue, Pittsburgh, Pennsylvania
    • Corresponding Author InformationReprint Address: David M. Lemonick, md, 215 Harrow Drive, Pittsburgh, PA 15238
  • ,
  • Robert Garvin, MD

      Affiliations

    • Department of General Surgery, The Western Pennsylvania Hospital, 4800 Friendship Avenue, Pittsburgh, Pennsylvania
  • ,
  • Howard Semins, MD (FACS)

      Affiliations

    • Department of General Surgery, The Western Pennsylvania Hospital, 4800 Friendship Avenue, Pittsburgh, Pennsylvania

Received 19 November 2004; received in revised form 31 May 2005; accepted 26 July 2005.

Abstract 

We present a case of acute torsion of the gallbladder in a young woman. Approximately 400 cases have been reported since 1898, mostly in elderly women, and the incidence appears to be increasing. The anatomy and pathophysiology that predispose patients to this rare surgical emergency are discussed. Several clinical and imaging findings can be used to distinguish gallbladder torsion from typical acute cholecystitis. By recognizing and treating gallbladder torsion early in its course, a low surgical morbidity and mortality can be achieved. The case presented highlights for emergency physicians some of the considerations in identification of patients with acute cholecystitis who are at highest risk of gangrene and perforation, their emergency treatment, and the timing of surgery.

Keywords:  gallbladder , volvulus , torsion , cholecystitis , abdominal

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PII: S0736-4679(06)00072-2

doi:10.1016/j.jemermed.2005.07.011

The Journal of Emergency Medicine
Volume 30, Issue 4 , Pages 397-401, May 2006