Naganuma S, Ishida H, Konno K, Hamashima Y, Hoshino T, Naganuma H, Komatsuda T, Ohyama Y, Yamada N, Ishida J, Masamune O
First Department of Internal Medicine, Akita University School of Medicine, 1-1-1 Hondo, Akita, Japan.
Abdom Imaging. 1998 Jan-Feb;23(1):67-72. doi: 10.1007/s002619900287.
Anomalous position of the gallbladder is relatively rare and has been reported only in isolated case reports. We tried to determine its ultrasound (US) findings on the basis of 18 such patients. In the left-side gallbladder group (nine patients), the gallbladder was imaged as an oval cystic mass in front of the pancreas. In all patients, the narrow neck of the gallbladder was clearly detected by US in the usual location before the main portal vein. Four of nine patients had small gallbladder stones. The retrohepatic gallbladder group (four patients) showed marked atrophy of the right lobe of the liver. Two patients had multiple gallstones in the bile ducts of the right lobe. All patients in the suprahepatic retrohepatic gallbladder group (four patients) were cirrhotic, and the anterior segment of the right lobe was markedly atrophied. In the intercostal scan, the gallbladder mimicked a perihepatic fluid. In the floating gallbladder group (one patient), the gallbladder was imaged as a cystic mass in the anterior abdominal wall. Surgical intervention showed a severely inflamed gallbladder, with small stones adhered into the anterior abdominal wall and partially ruptured. Knowledge of the wide range of US findings of malposition of the gallbladder helps in avoiding misdiagnosis.
胆囊异位相对罕见，仅有个别病例报告。我们试图基于18例此类患者确定其超声（US）表现。在左侧胆囊组（9例患者）中，胆囊在胰腺前方呈椭圆形囊性肿块成像。所有患者中，超声均能在主门静脉之前的常规位置清晰检测到胆囊的狭窄颈部。9例患者中有4例有小胆囊结石。肝后胆囊组（4例患者）显示肝右叶明显萎缩。2例患者右叶胆管有多发胆结石。肝上肝后胆囊组（4例患者）所有患者均为肝硬化，右叶前段明显萎缩。在肋间扫描中，胆囊类似肝周液体。在漂浮胆囊组（1例患者）中，胆囊在前腹壁呈囊性肿块成像。手术干预显示胆囊严重发炎，有小结石附着于前腹壁且部分破裂。了解胆囊位置异常的广泛超声表现有助于避免误诊。
