title: [Gallbladder volvulus: Diagnostic and surgical challenges].
abstract: BACKGROUND
  The gallbladder volvulus is defined as the rotation of the gallbladder on its mesentery along the axis of the cystic duct and cystic artery. It is an extremely rare surgical disease and definitive diagnosis is usually made during surgery.
  
  
  METHODS
  A 78 year old woman presented with upper right quadrant abdominal pain, with no comorbidities and no other accompanying symptoms. Analysis revealed haemodynamic instability and leukocytosis. Computed tomography of abdomen showed an acute cholecystitis. During emergency right hypochondrium laparotomy, the gallbladder was found to be twisted counterclockwise with huge gangrenous gallbladder distal. Open cholecystectomy was performed and after the surgery, the patient was discharged in a few days.
  
  
  CONCLUSIONS
  Gallbladder volvulus, or gallbladder torsion, is a rare condition and should be considered when clinical and imaging findings of complicated cholecystitis are present. The performance of urgent laparoscopic surgery would be first option to avoid perforation, peritonitis and haemodynamic instability.
authors.affiliation: Departamento de Cirugía General, Hospital Ramón y Cajal, Madrid, España. Electronic address: pedroabadiab@gmail.com.
authors.forename: Pedro
authors.initials: P
authors.lastname: Abadía-Barnó
authors.affiliation: Departamento de Cirugía General, Hospital Ramón y Cajal, Madrid, España.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Coll-Sastre
authors.affiliation: Departamento de Radiología, Hospital Ramón y Cajal, Madrid, España.
authors.forename: Carmen
authors.initials: C
authors.lastname: Picón-Serrano
authors.affiliation: Departamento de Cirugía General, Hospital Ramón y Cajal, Madrid, España.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Sanjuanbenito-Dehesa
authors.affiliation: Departamento de Cirugía General, Hospital Ramón y Cajal, Madrid, España.
authors.forename: Jacobo
authors.initials: J
authors.lastname: Cabañas-Montero
mesh_terms: D000368:Aged; D002763:Cholecystectomy / Q000379:methods*; D002764:Cholecystitis / Q000000981:diagnostic imaging; D002769:Cholelithiasis / Q000000981:diagnostic imaging; D003951:Diagnostic Errors; D004630:Emergencies; D005260:Female; D005704:Gallbladder / Q000473:pathology; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D005734:Gangrene; D006801:Humans; D007813:Laparotomy; D009336:Necrosis; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000000981:diagnostic imaging* / Q000601:surgery*
keywords: Cholecystectomy; Cholecystitis; Colecistectomía; Colecistitis; Colelitiasis; Gallbladder volvulus; Gallstones; Vólvulo de vesícula biliar