Pu Ta-Wei, Fu Chun-Yu, Lu Huai-En, Cheng Wei-Tung
Ta-Wei Pu, Chun-Yu Fu, Huai-En Lu, Department of Surgery, Song Shan Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
World J Gastroenterol. 2014 Oct 14;20(38):14068-72. doi: 10.3748/wjg.v20.i38.14068.
Gallbladder torsion is a rare, acute abdominal disease. It was first reported by Wendell in 1898. Since then, only 500 cases have been reported. Gallbladder torsion occurs in all age groups, although it usually appears in the latter stages of life. The occurrence ratio between women and men is 3:1. Most cases are diagnosed during surgery. The main treatment is surgical detorsion and cholecystectomy. Despite progress in radiologic imaging diagnosis, it is not easy to obtain a precise preoperative diagnosis of gallbladder torsion. In previous reports, only 9.8% of all gallbladder torsion cases were diagnosed preoperatively. We present a case of acute body-neck gallbladder torsion in an elderly man, and we review the radiologic findings of magnetic resonance imaging, computed tomography, and ultrasonography. The radiologic findings in the present case were helpful in obtaining a preoperative diagnosis of gallbladder torsion. The diagnosis was confirmed by T2-weighted magnetic resonance images, which showed an intra-gallbladder segment located between the body and neck of the gallbladder, with a notable crease within this segment.
胆囊扭转是一种罕见的急性腹部疾病。1898年由温德尔首次报道。自那时以来，仅报告了500例病例。胆囊扭转可发生于所有年龄组，尽管通常出现在生命后期。女性与男性的发病率之比为3:1。大多数病例在手术中被诊断出来。主要治疗方法是手术复位和胆囊切除术。尽管放射影像学诊断取得了进展，但要获得胆囊扭转的精确术前诊断并不容易。在以往的报告中，所有胆囊扭转病例中只有9.8%在术前被诊断出来。我们报告一例老年男性急性胆囊体颈部扭转病例，并回顾磁共振成像、计算机断层扫描和超声检查的影像学表现。本病例的影像学表现有助于获得胆囊扭转的术前诊断。通过T2加权磁共振图像确诊，该图像显示胆囊内有一段位于胆囊体部和颈部之间，该段内有明显的褶皱。
