Acute cholecystitis due to a gall bladder torsion

Gallbladder torsion is an unusual cause of an acute abdomen that can be mortal. It is presenting in variable ways, but the most common is symptomatology similar to acute cholecystitis. Clinical manifestations and imaging features can facilitate diagnosis, and treatment is detorsion with cholecystectomy. A 26-year-old male presented to the emergency department with intense abdominal pain, vomiting. The patient did not respond to symptomatic treatment and continued to present pain, nausea, and vomiting. The Ct scan showed signs of acute cholecystitis. The patient underwent laparoscopic cholecystectomy and found that the gallbladder was gangrene, enlarged due to torsion. Detorsion and cholecystectomy were carried out without complications. •Gall bladder torsion is an unusual challenging cause of acute cholecystitis.•It's mechanism is explaining by mesenteric anatomical variations.•Gall bladder torsion should be suspected as a differential diagnosis for right upper quadrant pain.•Prompt surgical management is the gold standard.•Gall bladder volvulus is associated with a high rate of mortality and morbidity.