Volvulus of the gallbladder.

Torsion of volvulus of the gallbladder is a rare condition. Approximately 300 cases have been reported since the first description by Wendel in 1898 (Ann Surg 1898; 27: 199). This entity appears most often in the elderly, with either acute, or recurrent, subacute symptoms. Such symptoms may mimic a number of other more common intraabdominal emergencies. Although the etiology is unknown, certain predisposing factors have been identified. Of these, the only one that is constant is the presence of the gallbladder on a mobile mesentery ("floating" gallbladder). Torsion occurs when this gallbladder twists around the cystic duct and artery, with subsequent occlusion of bile and blood flow. Diagnosed early and treated with cholecystectomy, this disease has a low mortality rate, between 3 and 5%. We have treated a case of acute torsion of the gall bladder at the Mount Sinai Hospital and have reviewed the existing literature.