title: Volvulus of the gall bladder diagnosed by ultrasonography, computed tomography, coronal magnetic resonance imaging and magnetic resonance cholangio-pancreatography.
abstract: A 54-year-old woman was admitted to our hospital with the complaint of right upper quadrant pain. Upon physical examination the vital signs of the patient were within normal ranges. Ultrasonography and computed tomography (CT) examination of the abdomen was obtained, which demonstrated a large dilatated cystic structure, measuring approximately 68.6 mm multiply 48.6 mm, with marked distension and inflammation. Additionally, the enhanced CT was characterized by the non-enhanced wall of the gallbladder. As the third examination in this study, magnetic resonance imaging (MRI), namely coronal MRI and magnetic resonance cholangio-pancreatogra (MRCP), were performed. The MRCP demonstrated a dilatation of the gallbladder but detected no neck of the gallbladder. Simple cholecystectomy was performed. Macroscopic findings included a distended and gangrenous gallbladder, and closer examination revealed a counterclockwise torsion of 360 degrees on the gallbladder mesentery. Coronal MRI and MRCP showing characteristic radiography may be useful in making a definitive diagnosis.
authors.affiliation: Department of Emergency and Disaster Medicine, Gifu University, 1-1 Yanagido, 501-1194, Gifu City, Japan. nobuhisa517@hotmail.com
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Matsuhashi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Satake
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yawata
authors.forename: Eri
authors.initials: E
authors.lastname: Asakawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Mizoguchi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kanematsu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kondo
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yasuda
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nonaka
authors.forename: Chihiro
authors.initials: C
authors.lastname: Tanaka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Misao
authors.forename: Shinji
authors.initials: S
authors.lastname: Ogura
mesh_terms: D049448:Cholangiopancreatography, Magnetic Resonance; D005260:Female; D005704:Gallbladder / Q000002:abnormalities* / Q000000981:diagnostic imaging; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography