Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 28, 2006; 12(28): 4599-4601
Published online Jul 28, 2006. doi: 10.3748/wjg.v12.i28.4599
Volvulus of the gall bladder diagnosed by ultrasonography, computed tomography, coronal magnetic resonance imaging and magnetic resonance cholangio-pancreatography
Nobuhisa Matsuhashi, Shinichi Satake, Kazunori Yawata, Eri Asakawa, Takashi Mizoguchi, Masayuki Kanematsu, Hiroshi Kondo, Ichiro Yasuda, Kenichi Nonaka, Chihiro Tanaka, Atsushi Misao, Shinji Ogura
Nobuhisa Matsuhashi, Shinichi Satake, Kazunori Yawata, Eri Asakawa, Takashi Mizoguchi, Shinji Ogura, Department of Emergency and Disaster Medicine, Gifu University, 1-1 Yanagido, 501-1194, Gifu City, Japan
Masayuki Kanematsu, Hiroshi Kondo, Department of Radiology, Gifu University, 1-1 Yanagido, 501-1194, Gifu City, Japan
Ichiro Yasuda, Department of Gastroenterology, Gifu University, 1-1 Yanagido, 501-1194, Gifu City, Japan
Kenichi Nonaka, Chihiro Tanaka, Department of Surgical Oncology, Gifu University, 1-1 Yanagido, 501-1194, Gifu City, Japan
Atsushi Misao, Department of Surgery, Misao Hospital, Yotsuya-chou, 500-8088, Gifu City, Japan
Correspondence to: Nobuhisa Matsuhashi, MD, PhD, 1-1 Yanagido, Gifu City, 501-1194, Japan. nobuhisa517@hotmail.com
Telephone: +81-58-2306448
Received: April 5, 2006
Revised: April 12, 2006
Accepted: April 24, 2006
Published online: July 28, 2006
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 × 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-pancreatography (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.

Keywords: Volvulus of the gallbladder, Computed tomography, Magnetic resonance imaging, Magnetic resonance cholangio-pancreatography