Torsion of the gallbladder in pregnancy. A case report.

Background: Gallbladder torsion is rarely diagnosed in pregnancy, but prompt surgical intervention is necessary to avoid possible sepsis and death.
Case: A 28-year-old, African American woman at 30(6/7) weeks' gestation was admitted with the presumed diagnosis of acute cholecystitis. The patient was treated conservatively. However, on re-examination, the patient's physical examination and laboratory values worsened. She underwent an exploratory laparotomy, which revealed a twisted gallbladder. A cholecystectomy was performed after untwisting of the gallbladder. Postoperatively the patient did well and subsequently delivered a healthy infant at 38(2/7) weeks' gestation.
Conclusion: Surgical evaluation of an acute abdomen in pregnancy should not be delayed. For a presumed diagnosis of acute cholecystitis that does not improve after conservative measures are taken, gallbladder torsion should be added to the differential diagnosis.