Gallbladder volvulus ultrasound

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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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Ultrasound

Yeh et al have suggested some findings on ultrasound which are suggestive of torsion of the gallbladder:[1]

  • Signs of a floating gallbladder, which is when almost the entire gallbladder is located below the liver and is not in contact with the liver.
  • Signs of a twisted pedicle. The pedicle represents the combined cystic duct, cystic artery, and vein as well as the mesentery.
  • Signs of an inflamed gallbladder (gallbladder wall is diffusely thickened and hypoechoic).

The thickening of the gallbladder wall may not be uniform. The focal thinning (or normal thickness) at the fundal region may indicate possible perforation or impending perforation in this area. Localized fluid collections around the gallbladder is a suggestive complication.

  • Evaluation of blood flow in the cystic artery may be done with color doppler.[2]

References

  1. Yeh HC, Weiss MF, Gerson CD (1989). "Torsion of the gallbladder: the ultrasonographic features". J Clin Ultrasound. 17 (2): 123–5. PMID 2492561.
  2. Koplewitz BZ, Manson DE, Ein SH (1999). "Posttraumatic torsion of accessory lobe of the liver and the gallbladder". Pediatr Radiol. 29 (11): 799–802. PMID 10552054.

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