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Case report
Gall bladder torsion: a disease of the elderly
  1. Rowan David,
  2. Luke Traeger and
  3. Christopher McDonald
  1. Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
  1. Correspondence to Dr Rowan David; rowan.david319{at}gmail.com

Abstract

We describe the case of a gall bladder torsion in an elderly female patient, which was discovered during laparoscopic exploration for presumed acute cholecystitis. The rising incidence of this relatively uncommon process can be attributed to increasing life expectancy. Gall bladder torsion typically manifests in septuagenarians and octogenarians of the female gender, as seen in the presented case. It is thought that local mesenteric redundancy predisposes to the development of mechanical organoaxial torsion along the gall bladder’s longitudinal axis involving the cystic duct and artery. Clinicians must have a high index of suspicion for gall bladder torsion, as a mimicker of acute cholecystitis, in the described patient demographic. Preoperative diagnosis is challenging with the vast majority of reported cases being diagnosed intraoperatively, and only five cases preoperatively. Prompt surgical intervention results in an overall mortality rate of approximately 5%, while a delay in diagnosis can lead to catastrophic patient outcomes.

  • general surgery
  • gastrointestinal surgery
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Footnotes

  • Contributors RD consented the patient for the case report, and collected the relevant case notes and images, wrote the discussion and conclusion sections and formatted the report to BMJ standards. LT wrote the abstract, case introduction and synopsis. CM supervised the project and reviewed the paper prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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