PMC8693826_01
Preoperative findings in a 3-year-old child with gallbladder torsion who underwent laparoscopic cholecystectomy. A, Day 1 of admission: abdominal enhanced computed tomography shows swelling of the gallbladder with ascites. Contrast effects on the gallbladder wall are observed. B, Day 2 of admission: abdominal ultrasonography reveals exacerbation of gallbladder wall thickness, 12 mm in size, and lack of intramural blood flow.
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Abdominal enhanced computed tomography (CT) showed swelling of the gallbladder with ascites, as did the AUS images from the day of admission (Fig. 1A). AUS was carried out. An increase in the gallbladder wall thickness to 12 mm and a lack of intramural blood flow was noted (Fig. 1B), which led to a diagnosis of GT.
Intraoperative findings in a 3-year-old child with gallbladder torsion who underwent laparoscopic cholecystectomy. A, The gallbladder is twisted 270  counterclockwise at the level of cystic duct and mesentery. B, The gallbladder is untwisted clockwise to the natural position. There is a small amount of mesentery between the cystic duct and liver bed, which is classified as type I according to the Gross classification.
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After resection of the adhesion between the gallbladder and the greater omentum, the gallbladder was observed to be twisted 270  counterclockwise at the level of the cystic duct and mesentery (Fig. 2A). The gallbladder was easily untwisted clockwise to its natural position, which was classified as type I according to the Gross classification (Fig. 2B).