Ultrasonographic Diagnosis of Torsion of the Gallbladder

Kinjo Masayoshi, Kokubu Shigehiro, Nemoto Hiromu, Omiya Harumi, Aso Koichi

Torsion of the gallbladder is rare and is seldom diagnosed preoperatively. We have had two cases of torsion of the gallbladder. The first case was diagnosed by ultrasound as cholecystitis, but operation disclosed torsion of the gallbladder. In the second case ultrasonography was used effectively in making a preoperative diagnosis, in view of the learning experience provided by the earlier case. Ultrasonography showed a fluid-filled mass in contact with the duodenum, and this was interpreted as a distended gallbladder. In left recumbent position the gallbladder was located near the mid-abdominal line, just in front of the vertebra. The square configuration of the gallbladder, three layers of the gallbladder wall and the narrow-part of the gallbladder neck were displayed. On the transverse scan along the neck of the gallbladder ultrasound showed a light abnormal echo, and tortion was suspected. As time passed after the admission debris within the gallbladder thickened and increased in quantity. These conditions are highly indicative of torsion, and therefore alertness to these indicators is recommended for diagnosing torsion of the gallbladder by ultrasonography before surgery.

Ultrasonographic Diagnosis of Torsion of the Gallbladder

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