caa a22 4500 606171819 CHVBK 20210128100725.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s10140-015-1331-8 doi (NATIONALLICENCE)springer-10.1007/s10140-015-1331-8 The cystic duct knot sign: case report with description of a new ultrasound sign of gallbladder torsion [Elektronische Daten] [Anil Dasyam, Julie Koo, Margaret Stahlfeld Miller, Harry Sell Jr., Mitchell Tublin] Gallbladder torsion or volvulus is a rare but potentially lethal entity. We report the imaging findings of gallbladder torsion and describe a potentially novel ultrasound sign for the preoperative diagnosis of torsion. An 87-year-old woman presented with a 4-day history of right upper quadrant pain. An initial right upper quadrant ultrasound exam demonstrated cholelithiasis and findings of acute cholecystitis which included gallbladder distension, wall thickening, trace pericholecystic fluid, and a positive sonographic Murphy's sign. Gallbladder torsion was prospectively diagnosed on the subsequent contrast-enhanced CT scan of the abdomen based upon the abnormal transverse orientation of the gallbladder with the neck directed laterally. Ultrasound images were reviewed and a "knot”-like hyperechoic nodular appearance of the torsed cystic duct close to the gallbladder neck was clearly apparent. Prospective identification of the torsed cystic duct may prompt the ultrasound diagnosis of gallbladder torsion. American Society of Emergency Radiology, 2015 Gallbladder nationallicence Torsion nationallicence Volvulus nationallicence Ultrasound nationallicence Cystic duct nationallicence Knot sign nationallicence Dasyam Anil Department of Radiology, University of Pittsburgh School of Medicine and Medical Center, 15213, Pittsburgh, PA, USA aut Koo Julie Department of Radiology, University of Pittsburgh School of Medicine and Medical Center, 15213, Pittsburgh, PA, USA aut Stahlfeld Miller Margaret Department of Radiology, University of Pittsburgh School of Medicine and Medical Center, 15213, Pittsburgh, PA, USA aut Sell Jr. Harry Department of Surgery, University of Pittsburgh School of Medicine and Medical Center, 15213, Pittsburgh, PA, USA aut Tublin Mitchell Department of Radiology, University of Pittsburgh School of Medicine and Medical Center, 15213, Pittsburgh, PA, USA aut Emergency Radiology Springer Berlin Heidelberg 22/4(2015-08-01), 445-447 1070-3004 22:4<445 2015 22 10140 https://doi.org/10.1007/s10140-015-1331-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10140-015-1331-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Dasyam Anil Department of Radiology, University of Pittsburgh School of Medicine and Medical Center, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Koo Julie Department of Radiology, University of Pittsburgh School of Medicine and Medical Center, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Stahlfeld Miller Margaret Department of Radiology, University of Pittsburgh School of Medicine and Medical Center, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Sell Jr Harry Department of Surgery, University of Pittsburgh School of Medicine and Medical Center, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Tublin Mitchell Department of Radiology, University of Pittsburgh School of Medicine and Medical Center, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 773 0- Emergency Radiology Springer Berlin Heidelberg 22/4(2015-08-01), 445-447 1070-3004 22:4<445 2015 22 10140