The floating gallbladder
- PDF / 595,702 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 106 Downloads / 189 Views
CLASSICS IN ABDOMINAL RADIOLOGY
The floating gallbladder Katherine Copely1 · Adrian Dawkins1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
The “floating gallbladder” was first described by Wendel [1] in 1898, describing an inferiorly displaced gallbladder with an unusually long cystic duct. The relevance of the floating gallbladder is to recognize its propensity to undergo torsion and perforation, a serious complication which can prove fatal [2]. The gallbladder is normally securely fixed to the liver by mesentery within the gallbladder fossa (Fig. 1). However, a congenitally long, incomplete, or atrophied mesentery grants the gallbladder enough mobility to migrate and twist about the cystic duct resulting in gallbladder torsion. Careful scrutiny of cross-sectional imaging will reveal an inferiorly and medially or laterally displaced gallbladder with twisting of
* Adrian Dawkins [email protected] 1
Department of Radiology, University of Kentucky, 800 Rose Street, Lexington, KY 40536‑0293, USA
the cystic duct (Fig. 2). Imaging may also reveal a dilated fluid-filled gallbladder with a thickened edematous wall, tantamount to acute cholecystitis [3]. Patients with torsion of the gallbladder are typically elderly females and will most often present clinically with colicky abdominal pain [2, 3]. Since gallstones may be absent, there may be a delay in the diagnosis of acute cholecystitis. Once detected, the floating gallbladder with associated torsion will require emergent surgical intervention; therefore timely diagnosis is key.
Fig. 1 T2 weighted, fat suppressed, coronal oblique magnetic resonance cholangiopancreatography (MRCP) image demonstrating normal position of the gallbladder. The gallbladder is seated within the gallbladder fossa (arrow) and closely applied to the liver parenchyma
13
Vol.:(0123456789)
Abdominal Radiology
Compliance with ethical standards Conflict of interest The authors declare that they have no conflict of interest.
References 1. Wendel AV. VI. A Case of Floating Gall-Bladder and Kidney complicated by Cholelithiasis, with Perforation of the Gall-Bladder. Ann Surg. 1898;27(2):199–202. 2. Boonstra EA, van Etten B, Prins TR, Sieders E, van Leeuwen BL. Torsion of the gallbladder. J Gastrointest Surg. 2012;16(4):882– 884. https://doi.org/10.1007/s11605-011-1712-6 3. Pu TW, Fu CY, Lu HE, Cheng WT. Complete body-neck torsion of the gallbladder: a case report. World J Gastroenterol. 2014;20(38):14068–14072. https: //doi.org/10.3748/wjg.v20. i38.14068 Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Fig. 2 T2 weighted, fat suppressed, coronal oblique MRCP image demonstrating an inferiorly displaced “floating gallbladder” with an edematous wall (chevrons). There is twisting of the cystic duct as evidenced by the hypointense tethered appearance at the neck (arrow). Note the absence of gallstones
13
Data Loading...
