Gallbladder Volvulus Mimicking an Intra-abdominal Malignancy in an Elderly Patient on Warfarin: A Case Report

TL;DR

An elderly patient on warfarin had gallbladder volvulus mistaken for cancer, showing how rare conditions can mimic malignancies.

Contribution

This case highlights diagnostic challenges of gallbladder volvulus mimicking intra-abdominal malignancy in elderly patients.

Findings

Gallbladder volvulus presented with symptoms and imaging similar to lymphoma or colon cancer.

CT and ultrasound findings were critical in identifying the condition.

Early diagnosis and intervention are crucial to avoid mismanagement in elderly patients.

Abstract

Gallbladder volvulus is a rare but potentially fatal condition that may present with symptoms mimicking intra-abdominal malignancy, including constitutional symptoms and mass-like imaging findings. We present the case of an 85-year-old female on chronic anticoagulation with warfarin, who was evaluated for an epigastric mass initially suspected to be lymphoma or colon cancer. CT imaging revealed a large, heterogeneous mass in the epigastric region, while ultrasound demonstrated significant gallbladder distention, wall thickening, and pericholecystic fluid. This report highlights the challenges in obtaining an accurate diagnosis and stresses the urgent need for swift imaging and intervention to distinguish between surgical emergencies and oncologic-related conditions in elderly patients.

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