Gallbladder torsion in a 4-year-old boy with history of gastrochisis: A case report

Introduction Gallbladder torsion is a rare cause of acute abdomen in all age groups, with only a few cases presented in children in literature. Case Presentation A four-year-old boy with earlier treated gastroschisis was admitted to hospital due to abdominal pain and vomiting. The upper part of abdomen was tender, the CRP (C-reactive protein, normal range under 10mg/l) level was mildly elevated to 68 mg/l, and the ultrasound showed an edematous gallbladder without any stones. In the MRI, a distended and fluid-filled gallbladder was visualized with vertically lying fundus pointing medially. The patient was taken to the operating room for an exploratory laparoscopy, which was converted to open laparotomy. During the laparotomy, a necrotic floating gallbladder with a 360-degree torsion around its axis was noted, and the gallbladder was removed. The patient recovered quickly after the operation without any complications. He was discharged on the fourth postoperative day. The pathology analysis of the removed gallbladder showed necrosis and mild inflammation. Conclusion Gallbladder torsion should be included in the differential diagnosis in children with a history of gastroschisis who develop acute abdominal pain.