title: Torsion of gall bladder, a rare entity: a case report and review article.
abstract: BACKGROUND
  Gallbladder torsion is a rare entity, which is often difficult to diagnose preoperatively. Since its first description in 1898 by Wendel, there have been over 500 documented cases in the literature. It is defined as rotation of the gallbladder on its mesentery along the axis of the cystic duct and cystic artery. Gallbladder torsion is more frequently encountered in the elderly with peak incidence in the 65-75 year old group, and a 3:1 female predominance. Gallbladder torsion typically presents as an acute abdomen requiring emergency surgery, and most cases are found as a surprise at surgery since preoperative diagnosis of gallbladder torsion is difficult. We report a case of acute gallbladder torsion in an elderly male and review the clinical aspect of gallbladder torsion.
  
  
  METHODS
  A 54-year old male presented to our department with a 5-day history of sudden onset colicky abdominal pain associated with vomiting, progressive abdominal distension and fever. Laparotomy through a chevron incision was performed and findings at operation included a gallbladder, which was necrotic and gangrenous, not attached to the liver by any mesentery. It was hanging by the attachments of cystic duct and cystic artery only, with a 360-degree clockwise torsion.
  
  
  CONCLUSIONS
  Gallbladder torsion is rare surgical emergency which requires a high index of suspicion for early preoperative diagnosis and prompt intervention. Treatment consists of cholecystectomy with a prior detorsion to avoid injury to the common duct.
authors.affiliation: Department of Anatomy, Peoples College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India.
authors.forename: Vanita
authors.initials: V
authors.lastname: Gupta
authors.forename: Vikrant
authors.initials: V
authors.lastname: Singh
authors.forename: Ajit
authors.initials: A
authors.lastname: Sewkani
authors.forename: Dipak
authors.initials: D
authors.lastname: Purohit
authors.forename: Rajneesh
authors.initials: R
authors.lastname: Varshney
authors.forename: Subodh
authors.initials: S
authors.lastname: Varshney