A 95-year-old man presented to the emergency department with abdominal pain in the right iliac fossa.
His personal history included a large dorsal kyphosis with no other relevant history.
She complained of abdominal pain in the right iliac fossa of 24 hours of evolution, progressive onset and intense character, without nausea or vomiting or other accompanying symptoms.
Physical examination revealed severe pain in the iliac fossa and right flank with defense and peritonitis.
Complementary tests: abdominal X-ray: no pathological findings; chest X-ray: no pathological findings; complete blood count: leukocytosis (12,500) with neutrophilia (
CT abdomen: intra-abdominal collection located in the IDF that sees the right parietocolic space.
With a diagnosis of acute abdomen compatible with complicated acute meningitis, a supra- and infraumbilical midline laparotomy was performed, finding a normal appendix.
A gallbladder volvulus with edematous, congestive vesicle and necrotic areas was evident.
A devolvulation of more than 180o and a regulated cholecystectomy were performed.
Postoperative course was uneventful and the patient was discharged on postoperative day 7.
Pathological examination revealed acute to lithiasis.
