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Torsion of the Gallbladder

JOHN L. BUTSCH, MD; FRED LUCHETTE, MD
Arch Surg. 1985;120(11):1323. doi:10.1001/archsurg.1985.01390350099022.
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To the Editor.—Unrecognized torsion of the gallbladder creates a catastrophic condition and should be borne in mind in the diagnosis of the acute abdomen. There have not been more than 300 cases reported in the literature, the first of which dates from 1898. However, Whipple and Sato1 believed that the number has increased.

Report of a Case.—An 86-year-old man presented with the complaint of a sudden onset of pain in the right upper abdominal quadrant. The pain was sharp and non-radiating, remained constant, and was associated with a fever throughout the night. There was no history of jaundice nor did he have any history of fatty food intolerance.

On physical examination the patient was flushed, with a rectal temperature of 39.05 °C. His pulse rate was 120 beats per minute. His sclera were clear and his tongue was dry. The abdomen was symmetric. There was marked guarding

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