Volvulus of the gall bladder diagnosed by ultrasonography, computed tomography, coronal magnetic resonance imaging and magnetic resonance cholangio-pancreatography.
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.
Matsuhashi
Nobuhisa
N
Department of Emergency and Disaster Medicine, Gifu University, 1-1 Yanagido, 501-1194, Gifu City, Japan. nobuhisa517@hotmail.com
Satake
Shinichi
S
Yawata
Kazunori
K
Asakawa
Eri
E
Mizoguchi
Takashi
T
Kanematsu
Masayuki
M
Kondo
Hiroshi
H
Yasuda
Ichiro
I
Nonaka
Kenichi
K
Tanaka
Chihiro
C
Misao
Atsushi
A
Ogura
Shinji
S
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