EP.TU.972Torsion of the gallbladder: a rare disease

Gallbladder torsion was first described as early as in the 19th century but there are only about five hundred cases reported in literature. This rare disease predominantly affects elderly women with a median age of 77 years.The female to male ratio is 4:1. Though the exact etiology is unknown, certain anatomical variants of the gallbladder are thought to increase one's predisposition to the condition. Gallbladder torsion is very difficult to diagnose preoperatively and even with all the advancements in imaging techniques, only about a quarter of cases are diagnosed preoperatively. Most cases like the index case are diagnosed during surgery Aim To review the diagnosis and management of gallbladder torsion in 78 year old female patient who presented acutely to our unit. Method Discussion on the presentation, assessment, imaging and preoperative findings to as well as the management plan adopted. Results A review of intraoperative findings, postoperative recovery of the patient and literature on gallbladder torsion. Conclusion Since the first case of laparoscopic cholecystectomy for torsion in 1994, 105 further cases have been reported. Of this, 28% were managed by laparoscopic surgery whilst 8% resulted in a laparoscopy converted to open procedure. one case of ERCP detorsion has been reported. A high index of suspicion together with improved imaging techniques can help to significantly improve the preoperative diagnosis of gallbladder torsion. Early operative management usually results in a good prognosis. Innovations imaging techniques to help improve preoperative diagnosis will be discussed.