Traumatic Gallbladder Rupture in a Pediatric Patient Misdiagnosed as Acute Appendicitis

We present an 8-year-old male with a history liver surgery as a neonate who presented to the emergency department with a chief complaint of abdominal pain. A computed tomography scan (CT) showed ascites with dilated loops of small bowel and the appendix was not visualized. The pediatric surgery team was consulted for possible perforated appendicitis. Patient was initially treated with conservative management. The patient became peritoneal and was taken for diagnostic laparoscopy. A laceration of the dome of his gallbladder was visualized and a cholecystectomy was performed. Traumatic gallbladder rupture is a rare entity and occurs in 2% of all blunt abdominal injuries. The diagnosis can be difficult to make due to nonspecific symptoms. While an avulsion to the gallbladder may be diagnosed on CT scan, gallbladder lacerations can be difficult to visualize on imaging. The practitioner must have a suspicion for gallbladder injury to aid in the diagnosis.