A case of gallbladder torsion for which ultrasound endoscopy was useful for preoperative diagnosis

The patient was a female in her 70s. She was brought to an emergency room with epigastric pain. An abdominal ultrasound confirmed gallbladder enlargement and gallbladder wall thickening, and then she was admitted to the hospital with a diagnosis of acute cholecystitis. Contrast-enhanced CT showed poor contrast of the gallbladder wall. Endoscopic ultrasound showed a break in the continuity from the neck of the gallbladder to the cystic duct and a spiral-like structure in the neck of the gallbladder, leading to a preoperative diagnosis of gallbladder torsion. Laparoscopic cholecystectomy released the torsion, and the gallbladder was removed. The patient was discharged from the hospital on the 10th day. Preoperative diagnosis is important because gallbladder torsion is often associated with necrotizing cholecystitis. Ultrasound endoscopy has a high spatial resolution and is excellent for evaluating the continuity of the cystic duct and spiral structures at the torsion site, we thus report ultrasound endoscopy may be useful in diagnosing gallbladder torsion.