Matsuhashi Nobuhisa, Satake Shinichi, Yawata Kazunori, Asakawa Eri, Mizoguchi Takashi, Kanematsu Masayuki, Kondo Hiroshi, Yasuda Ichiro, Nonaka Kenichi, Tanaka Chihiro, Misao Atsushi, Ogura Shinji
Department of Emergency and Disaster Medicine, Gifu University, 1-1 Yanagido, 501-1194, Gifu City, Japan.
World J Gastroenterol. 2006 Jul 28;12(28):4599-601. doi: 10.3748/wjg.v12.i28.4599.
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 multiply 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-pancreatogra (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.
一名54岁女性因右上腹疼痛入院。体格检查时患者生命体征在正常范围内。对腹部进行了超声检查和计算机断层扫描（CT），结果显示一个大的扩张性囊性结构，大小约为68.6毫米×48.6毫米，伴有明显扩张和炎症。此外，增强CT的特征是胆囊壁无强化。作为本研究的第三次检查，进行了磁共振成像（MRI），即冠状面MRI和磁共振胰胆管造影（MRCP）。MRCP显示胆囊扩张，但未发现胆囊颈部。实施了单纯胆囊切除术。宏观检查结果包括胆囊扩张和坏疽，进一步检查发现胆囊系膜逆时针扭转360度。显示特征性影像学表现的冠状面MRI和MRCP可能有助于做出明确诊断。
