Snapshot quiz 13/23

Published: 01/04/2013

Authors: Scott N, Maheswaran I and Jethwa P

An 86-year-old woman presented with sudden-onset upper abdominal pain. Examination revealed tenderness in the upper abdomen with all initial investigations being normal. Computed tomography showed a small amount of free fluid in the pelvis and a thin-walled distended gallbladder, but no obvious cause for the pain. At laparotomy a torted and infarcted gallbladder was found, and a cholecystectomy was therefore performed. The patient made an uneventful recovery. The authors advise that torsion of the gallbladder should be considered in any individual with sudden-onset upper abdominal pain and no signs of toxaemia.