A case of torsion of the gallbladder diagnosed preoperatively on MRCP

Torsion of the gallbladder is a relatively rare disease. It has been reported to be hard to diagnose preoperatively. We report a case of torsion of the gallbladder diagnosed preoperatively with striking finding on MRCP. An 85 years old female admitted to our hospital because of severe abdominal pain and vomiting. She was diagnosed acute cholecystitis and chololithiasis by findings on computed tomography and ultrasonogram. PTGBD and MRCP were performed. MRCP showed a tapering (smooth) interruption both side of the cystic duct. Because of this striking finding on MRCP, she was diagnosed torsion of the gallbladder preoperatively and underwent laparoscopic cholecystectomy. In the operation, the gallbladder was twisted clock wisely about 180 degrees, and noted as a Gross type II, floating gallbladder. In this case, MRCP revealed a tapering (smooth) interruption both side of the cystic duct. We consider that this striking finding is useful for diagnosis to distinguish torsion of the gallbladder from gallbladder (choledochal) stone and gallbladder cancer.