Volvulus of the gall bladder diagnosed by ultrasonography,computed tomography,coronal magnetic resonance imaging and magnetic resonance cholangio-pancreatography

一个 54 岁的女人与恰好上面的象限疼痛的抱怨进入我们的医院。在体格检查之上，病人的生活征在正常范围以内。Ultrasonography 和计算断层摄影术(CT ) 腹部的检查被获得，它表明了大 dilatated 膀胱的结构，多样地测量约 68.6 公里 48.6 公里，与显著扩张和发炎。另外，提高的 CT 被胆囊的非提高的墙描绘。作为在这研究的第三考试，磁性的回声成像(MRI ) ，也就是花冠 MRI 和磁性的回声 cholangio-pancreatogra (MRCP ) ，被执行。MRCP 表明了胆囊的膨胀，但是没检测胆囊的颈。简单胆囊炎被执行。包括的宏观的调查结果一扩张，坏疽的胆囊，和更仔细的检查在胆囊肠系膜上揭示了 360 度的逆时针方向的扭转。显示出典型 X 光线照相术的花冠 MRI 和 MRCP 可能在做权威的诊断是有用的。

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.