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Case Reports
. 2012 Jul-Sep;97(3):235-8.
doi: 10.9738/CC151.1.

Torsion of the gallbladder diagnosed by magnetic resonance cholangiopancreatography

Minoru Fukuchi  1 , Kenji Nakazato, Hisanori Shoji, Hiroshi Naitoh, Hiroyuki Kuwano
Affiliations
Case Reports

Torsion of the gallbladder diagnosed by magnetic resonance cholangiopancreatography

Minoru Fukuchi et al. Int Surg. 2012 Jul-Sep.

Abstract

Torsion of the gallbladder is a rare entity that is difficult to diagnose preoperatively, the principal differential diagnosis being cholecystitis. The condition occurs most often in the elderly. Although its etiology is unknown, the presence of a redundant mesentery is a prerequisite for torsion. Computed tomography, ultrasound, and magnetic resonance cholangiopancreatography can provide important diagnostic clues. Torsion of the gallbladder occurs when it twists axially, with subsequent occlusion of bile or blood flow. Therefore, prompt surgical treatment is necessary in order to prevent necrosis and perforation. In the present study, we report a case of torsion of the gallbladder diagnosed by magnetic resonance cholangiopancreatography. This condition was successfully treated by laparoscopic cholecystectomy.

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Figures

Fig. 1
Fig. 1
Abdominal CT indicates a massively distended GB (arrow) with heterogeneous contents.
Fig. 2
Fig. 2
MRCP shows a pulled CBD (arrow) near the neck of the GB (arrow).
Fig. 3
Fig. 3
During the laparoscopic procedure, the GB (arrow) was found to be ischemic and floating away from the liver bed. (a) The GB was rotated 360° counterclockwise around its axis at the level of the cystic duct (CD; arrow) and artery. (b) Untwisting followed by cholecystectomy was successfully performed. CBD is indicated by an arrow.
See this image and copyright information in PMC

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