Gallbladder volvulus CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

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CT

Kitgawa H et al has provided a criteria based upon CT findings for the diagnosis of gallbladder volvulus.[1]

  • The criteria is
    • Collection of fluid between the gallbladder and the gallbladder fossa of the liver.
    • A horizontal positioning of the long axis of the gallbladder.
    • A well-enhanced cystic duct located on the right side of the gallbladder.
    • Marked edema with thickening of the wall (signs of inflammation).

The contrast-enhanced multidetector computed tomography (MDCT) scan clearly shows twisted pedicle of the cystic duct and gallbladder mesentery on the right side of the gallbladder. This is called "whirl sign," and is a definitive diagnosis of gallbladder torsion.

References

  1. Kitagawa H, Nakada K, Enami T, Yamaguchi T, Kawaguchi F, Nakada M; et al. (1997). "Two cases of torsion of the gallbladder diagnosed preoperatively". J Pediatr Surg. 32 (11): 1567–9. PMID 9396527.
  2. Tajima Y, Tsuneoka N, Kuroki T, Kanematsu T (2009). "Clinical images. Gallbladder torsion showing a "whirl sign" on a multidetector computed tomography scan". Am J Surg. 197 (1): e9–10. doi:10.1016/j.amjsurg.2008.01.030. PMID 18723147.

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