Pediatr Emerg Med J.  2022 Jun;9(1):61-64. 10.22470/pemj.2022.00416.

A 13-year-old boy with strangulation of the floating gallbladder by the lesser omentum

• Kim MK
• Shin SH

• KMID: 2531533
• DOI: http://doi.org/10.22470/pemj.2022.00416

Abstract

The selection of imaging modality is important in emergency departments because symptoms in children are usually unclear. In children with abdominal pain, differential diagnosis ranges from common diseases to rare entities requiring surgical therapy. Unremarkable findings on routine investigation, such as laboratory tests and plain radiographs, cannot rule out the surgical entities. Close observation and, if needed, further imaging tests are necessary in emergency departments or even in wards for children with recurrent or worsening abdominal pain. We report a rare case of a 13-year-old boy with strangulation of the floating gallbladder by the lesser omentum. This article features the imaging findings of the rare surgical entity.

Keyword

Abdominal pain; Cholecystitis; Omentum; Pediatrics; Tomography, X-Ray Computed; Ultrasonography

Figure

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  Fig. 1. Findings of computed tomography. The swollen fundus and body of the gallbladder are noted with a narrowed portion (arrow, A). The gallbladder wall-thickening and pericholecystic fluid collection are also seen, suggesting acute cholecystitis (arrow, B).

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  Fig. 2. Laparoscopic findings. The gangrenous change (asterisk, A) is seen on the fundus and body of the floating gallbladder. The Hartmann’s pouch is encircled by the band of the lesser omentum (arrow, A). This band is attached to the inferior margin of the liver (arrow, B).

Reference

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