Ultrasonographic Diagnosis of Acute Gallbladder Torsion in a Child: A Case Report.

Abstract

Gallbladder torsion is an extremely rare condition in the pediatric population. A 32-month-old boy presented with paroxysmal abdominal pain and vomiting. An initial dedicated intestinal ultrasonography yielded false-negative results, and conservative treatment failed to relieve symptoms. Repeat examinations revealed elevated inflammatory markers; extended abdominal ultrasonography identified an enlarged and twisted gallbladder with wall thickening and absent mural vascularity. Emergency surgery confirmed 360° gallbladder torsion with ischemic necrosis, and laparoscopic cholecystectomy was performed successfully. Notably, this case represents one of the few reported instances of gallbladder torsion in children under 3 years of age with an initial false-negative ultrasound examination, highlighting critical diagnostic pitfalls in pediatric acute abdomen. This report underscores the value of ultrasonography in the early diagnosis of pediatric gallbladder torsion through recognition of typical imaging signs and proactive extended scanning when clinical deterioration occurs.