Gallbladder torsion, also known as gallbladder volvulus, refers to the twisting of the gallbladder on its long axis, compromising its vascular supply. Torsion of the gallbladder is a rare condition that is usually identified intraoperatively. It primarily occurs in elderly persons between the ages of 65-75 years; the majority (84%) of all patients are women. Patients with a long, redundant mesentery or an incomplete mesentery covering the cystic duct and artery are at risk of developing gallbladder torsion. The exact precipitating factor has not been identified, but sudden movements, strong peristaltic movements of surrounding organs, adhesions, atherosclerosis of the cystic artery, sigmoid volvulus, and spinal kyphoscoliosis have been implicated.
Gallbladder torsion can be categorized as incomplete or complete. Incomplete torsion is characterized by waves of slowly progressive pain, whereas complete torsion presents with acute onset of pain. Identification of torsion on imaging should prompt emergent surgical intervention, as uncorrected complete torsion may lead to gangrene of the gallbladder.