Gallbladder torsion: preoperative diagnosis by MDCT

Abstract

The patient was a 80-year-old female who was diagnosed as having gallbladder torsion preoperatively. To out knowledge, this is the first reported case diagnosed by CT with a multidetector CT scanner. The abdominal CT showed a V-shape distortion of the extrahepatic ducts, twisting cystic artery with "Whirl's sign", distended and enlarged gallbladder with wall hemorrhage. A definitive diagnosis of gallbladder torsion was made by CT preoperatively. If treated surgically, gallbladder detorsion before cholecystectomy is a helpful technique to avoid bile duct injury. This condition should be suspected in elderly women with acute abdominal pain of unknown origin, and MDCT with multiplanar reformation is very useful in making a definitive diagnosis.