# Gallbladder torsion treated with laparoscopic surgery on the fifth day after onset

## TL;DR

An 83-year-old woman with gallbladder torsion was initially misdiagnosed with cholecystitis but successfully treated with laparoscopic surgery five days after symptoms began.

## Contribution

The case highlights the diagnostic challenge of gallbladder torsion and suggests semi-emergency surgery as a viable option when symptoms are not severe.

## Key findings

- Gallbladder torsion was confirmed intraoperatively despite initial diagnosis of cholecystitis.
- Semi-emergency laparoscopic surgery resolved the condition effectively.
- Computed tomography showed gallstone and enlarged gallbladder but failed to confirm torsion preoperatively.

## Abstract

Gallbladder torsion is a rare condition and has very similar symptoms to acute cholecystitis and is often difficult to diagnose preoperatively. We report the case of a patient who was initially diagnosed with cholecystitis and subsequently underwent surgery with a diagnosis of gallbladder torsion on the fifth day after onset. An 83-year-old woman presented with a 2-day history of gradually progressive lower abdominal pain. Computed tomography showed a gallstone and an enlarged gallbladder. We diagnosed the patient with gallstone cholecystitis and admitted her to hospital. As the abdominal pain had not improved by the next day, we performed a laparoscopic cholecystectomy on the fifth day onset. Intraoperative findings confirmed necrosis of the gallbladder and torsion at the gallbladder neck. Gallbladder torsion may be misdiagnosed as acute cholecystitis. When abdominal symptoms are not severe as in our case, semi-emergency surgery may be a viable option.