Contrasting Pathogenic Mechanisms in Acute and Subacute Gallbladder Volvulus: Analysis of Two Cases with Different Degrees of Torsion.

Gallbladder volvulus is a rare but potentially severe condition that requires urgent surgical intervention. This report presents two contrasting cases of gallbladder volvulus with distinct pathogenic mechanisms and degrees of torsion. The first case involves a 97-year-old female who presented with acute symptoms and 270° torsion, leading to complete gallbladder necrosis (Gross type II). The second case involves a 52-year-old male with a subacute presentation and 90° torsion, resulting in incomplete necrosis (Gross type I). Both cases underwent successful laparoscopic cholecystectomy, completed in 69 and 59 minutes, respectively. Analysis of these cases reveals that the degree of torsion correlates with the acuity of presentation and the extent of tissue ischemia, which influences the timing of surgical intervention. This study underscores the importance of early recognition and prompt surgical management in gallbladder volvulus, regardless of presentation pattern. Although gallbladder volvulus predominantly affects elderly females, it can occur across different age groups and genders, highlighting the need for increased clinical awareness to achieve optimal outcomes.