Gallbladder torsion in a child diagnosed by ultrasonography and treated by laparoscopic cholecystectomy

Abstract

ABSTRACT Gallbladder torsion is a very rare cause of acute abdominal pain. It usually occurs in elderly women, when the gallbladder twists around its mesentery. Contributory factors for this to occur are postulated to be an associated anatomical abnormality of the vascular pedicle to the gallbladder or the presence of an abnormally long mesentery from the gallbladder to the liver bed allowing it to float freely. Clinical symptoms are nonspecific, usually similar to biliary colic with acute onset of abdominal pain, nausea and vomiting. The absence of gallbladder stone with signs of acute cholecystitis on imaging findings can suggest a torsion of the gallbladder. This disease is a life - threatening emergency that requires urgent cholecystectomy. However, cases of gallbladder torsion in children undergoing laparoscopic cholecystectomy are rarely reported nationally or internationally due to the uncommonness of the disease. We report a 3 - year - old child admitted to the hospital with symptoms of acute abdominal pain and vomiting. Ultrasonography demonstrate a distended gallbladder, with a multilayered wall, which contained no stones. Laparotomy was performed and the gallbladder was found to be twisted around its pedicle. Cholecystectomy was performed. After surgery, the child was stable and was discharged from the hospital after 5 days of treatment.