Tijdschrift voor Geneeskunde vol:62 issue:1 pages:39-42
A case of torsion of the gallbladder in a 2-year-old child is reported to focus attention on this rare condition. Symptoms consist of acute abdominal pain with or without a palpable mass in the right upper quadrant of the abdomen.
Torsion of the gallbladder is due to an anatomic variation, in which the gallbladder shows an abnormal mobility due to the presence of a congenital or an acquired mesentery with loss of fixation to the inferior liver margin.
Ultrasonography is helpful for the preoperative diagnosis. Typical radiologic features consist of a free-floating gallbladder and a conical structure connecting the gallbladder to the liver. Non-specific features are a dilatation of the gallbladder with thickening of the wall, and with signs of inflammation.
The preoperative differential diagnosis includes intussusception, (a)calculous cholecystitis, acute hydrops of the gallbladder, and a high retrocaecal appendicitis. The treatment is prompt cholecystectomy in order to avoid gangrene, perforation, and peritonitis.