Abstract-Gallbladder volvulus is an unusual cause of acute abdomen. After the first case published by Wendel, about 500 cases have been documented in the medical literature.This condition is defined as torsion of the gallbladder around its The one presented here is a case of a 85 year-old woman who complained of right subcostal pain since 48 hours without fever. -walled gallbladder which was ischemic and gangrenous without perforation. Cholecysectomy was performed with a cho langiography which was normal. The anatomopathologic examination confirmed the diagnosis of acute gangrenous cholecystitis. Gallbladder volvulus is a non-frequent cause of acute cholecystitis. # I. Case Report 85 year-old woman was admitted for a right upper abdominal pain, nausea, vomiting without abdominal surgery or trauma, laboratory analysis revealed hyperleucocytosis with normal liver function tests. The echography revealed thick-walled gallbladder without cholelithiasis and a common bile duct dilatation of 10 mm. Right upper quadrant tenderness and positive Murphy's sign were detected on physical examination. On surgical exploration through a right subcostal incision, there was a 100 ml of serohemorrhagic exudate with complete torsion of the gallbladder along the axis of the cystic duct (figure1), the cystic duct was so long which measured 6 cm, it is cut at a distance of 1 cm of the c ommon bile duct, introperativecholangiography was normal (figure2), standard open choecystectomy was performed. Bile culture was positive for Echerchia Coli, therefore; antibiotheraby was adapted. Her p ostoperative c ourse was uneventful, and she was discharged on the3 rd postoperative day. # Discussion Gallbladder volvulus is defined as torsion of the gallbladder around its artery and duct in case of a long and flask mesentery (1). After the first case published by Wendel in 1898(2), about 500 cases have been documented -old patients (3,4). Gallbladder torsion occurs most often in elderly patients (5,6,7), but several cases were rep orted in children (8,9). The one presented here was a surprise intraoperative diagnosi s because of the presumed gallbladder volvulus commonly presents as acute cholecystitis and is rarely diagnosed preoperatively. This condition should be always suspected when making the patients especially in women. Magnetic resonance cholangiopancreatography (MRCP) i s very useful in making preoperative definitive diagnosis of gallbladder torsion (10). Gallbladder torsion was reported in pregnancy (11). Gallbladder volvulus should be thought suitable medical treatment. Delayed diagnosis can lead to dangerous c omplication such as necrosis and perforation of the gallbladder with a generalized peritonitis,consequently;mortality is increased especially in elderly patients who have often other comorbidities (5). laparoscopic detorsion and removal of gallbladder is the treatment of choice for gallbladder volvulus (4,12). # III. # Conclusion Gallbladder volvulus is a rare cause of acute abdomen which i s rarely diagnosed before surgery. It should be added to the differential diagnosis of acute cholecystitis that does not improve after medical treatment especially in elderly women. Early diagnosis and urgent cholecystectomy in necessary for optimal prognosis. Volume XIV Issue V Version I Year ( ) ![gallbladder detortion is performed, fever since 48 hours.She had an insulin The echography revealed a large thick intraoperative view of gallbladder torsi on, B hemorrhagic exudate with complete torsion of the gallbladder dependent diabetes with no history of previous Laparotomy through a right subcostal incision revealed a sero with a common bile duct diameter of 10mm without stones. Gallbladder Volvulus: A Case Report and Review Mounzer Dgheem ? & Charles Mouliade ?](image-2.png "") 1![Figure 1 : A)](image-3.png "Figure 1 :") 2![Figure 2 : Intraoperative cholangiography shows the long cystic duct with no stones in common bile duct II.](image-4.png "Figure 2 :") * Gallbladder volvulus: review of the literature and report of a case ORTarhan IBarut HDinelek Turk J Gastroenterol 17 3 2006 Sep * A case of floating gallbladder and kidney complicated by cholelithiasis with perforation of the gallbladder AVWendel Ann Surg 27 1898 * Gallbladder volvulus: rep ort of two original cases and review of the literature AAShaikh ACharles SDomingo GSchaub Am Surg 71 1 2005 Jan * Complete bodyneck torsion of the gallbladder: A case rep ort TWPu CYFu HELu WTCheng World J Gastroenterol 20 38 2014 Oct 14 * Gallbladder torsion: report of four cases and review of the literature AMarano EYahchouchy-Chouillard RSpinelli AIannelli TAura AFingerhut Asian J Surg 25 2 2002 Apr * Uncommon cause of ac ute abdomen: volvulus of gallbladder with necrosis. Case report and review of literature CBagnato PLippolis GZocco CGalatioto MSeccia 2011 Mar-Apr Ann ItalChir 82 * Volvulus of the gallbladder: laparoscopic detorsion and removal. SurgEndosc SYKim JTMoore 2003 Nov 17 1849 * Diagnosis and treatment of gallbladder torsion in a 6 year old TCFarnsworth CAWeiss JSLS 17 2 2013 Apr-Jun * Laparoscopic treatment for torsion of the gallbladder in a 7-year-old female AMatsuda KSasajima MMiyamoto HMaruyama TYokoyama SSuzuki TMatsutani ASugiura KYanagi AMatsushita HArai TTajiri JSLS 13 3 2009 Jul-Sep * Preoperative diagnosis of gallbladder torsion by magnetic resonance cholangiopancreatography MUsui SMat Suda HSuzuki YOgura Scand J Gastroenterol 35 2 2000 Feb * Torsion of the gallbladder in pregnancy. A case report KKleiss LChoy-Hee RFogle MLindsay J Reprod Med 48 3 2003 Mar * Volvulus of the gallbladder: laparoscopic detorsion and removal. SurgEndosc SYKim JTMoore 2003 Nov 17 1849