Sudden abdominal pain. Nausea and vomit. No fever. Recently significant loss of weight. Elevated CRP and WBC. Midline palpable resistance .
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Enlarged edematous gall bladder with wall thickening. The gall bladder is located outside its normal anatomic position and is horizontally oriented, a so called "free floating gall bladder". Slightly dilated intrahepatic bile ducts. Evidence of kyphoscoliosis and thin patient
Surgery revealed a large necrotic gallbladder which was twisted 180° counterclockwise.
Gallbladder volvulus is a relatively rare condition and often not described pre-surgically.
Risk factors are described as follows:
- old age
- female gender (3:1)
- thin patient
- Bagnato C, Lippolis P, Zocco G, Galatioto C, Seccia M. Uncommon cause of acute abdomen: volvulus of gallbladder with necrosis. Case report and review of literature. (2011) Annali italiani di chirurgia. 82 (2): 137-40. Pubmed