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Torsion of the gallbladder in a thirteen year old boy--case report
1Department of Pediatric Surgery, Kurume University School of Medicine, Japan.
Insights
Gallbladder torsion is a rare pediatric condition. Ultrasonography showing gallbladder dislocation is key for preoperative diagnosis, aiding timely surgical intervention.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Radiology
Background:
- Gallbladder torsion is an uncommon surgical emergency in children, with limited reported cases globally.
- Preoperative diagnosis is challenging, often leading to delayed treatment and potential complications.
Observation:
- A pediatric patient presented with symptoms suggestive of acute cholecystitis.
- Intraoperative findings revealed a significantly enlarged gallbladder, twisted 540 degrees around the cystic duct.
Findings:
- Surgical management involved successful cholecystectomy and abdominal drainage.
- The patient recovered well, with discharge on postoperative day 13.
Implications:
- Ultrasonographic evidence of gallbladder dislocation is a critical indicator for suspecting torsion.
- Early diagnosis and surgical intervention are crucial for favorable outcomes in pediatric gallbladder torsion.
Abstract:
Torsion of the gallbladder in a child is rare and only 23 cases in children have been reported in Japan. A preoperative diagnosis is very difficult and only four cases have been diagnosed, preoperatively, to date. In the case reported here the suspected preoperative diagnosis was an acute cholecystitis. During the operation, the gallbladder was found to be enlarged to twice the normal size and twisted 540 degrees in a clockwise direction around the cystic duct. A cholecystectomy with abdominal drainage was successfully performed; and the patient was discharged in good condition, 13 days after the operation. It was concluded that one of the most important features for the preoperative diagnosis of torsion of the gallbladder is a dislocation on ultrasonography.