Multiseptate gallbladder

Multiseptate gallbladder in a pediatric pateint: A case report and review of literature

INTRODUCTION

Multiseptate gallbladder (MSG) is an uncommon congenital condition characterized by internal septa dividing the gallbladder into multiple compartments. This condition poses unique challenges in diagnosis and management due to its rarity and varied clinical presentations.

CASE PRESENTATION

A 4-year-old female presented with a three-month history of colicky abdominal pain. Imaging studies confirmed MSG with gallbladder sludge but no stones. Despite normal initial lab results, the patient underwent a laparoscopic cholecystectomy due to persistent symptoms, resulting in a full recovery with no complications over six months.

DISCUSSION

The etiology of MSG is unclear, with several embryological theories proposed. Diagnosis relies on imaging techniques like ultrasound and MRI. A literature review of 37 pediatric cases shows a higher prevalence in females and varied clinical presentations. Management includes conservative observation or surgical intervention, with cholecystectomy proving effective for symptomatic cases.

CONCLUSION

Multiseptate gallbladder is a rare congenital anomaly in pediatric patients, often requiring imaging techniques like MRCP for accurate diagnosis. While many cases remain asymptomatic and can be managed conservatively, surgical intervention is beneficial for those with persistent symptoms. Early diagnosis and tailored management lead to favorable outcomes.

Incidental Diagnosis of Honeycomb Gallbladder on Point-of-Care Ultrasound

Honeycomb gallbladder is a term that has been coined to describe a multiseptated gallbladder. In this case report, we describe a pregnant patient who had an extensive work-up of her abdominal pain and was found to have this incidental finding.

Multiseptate gallbladder: A case report and literature review

RATIONALE

Multiseptate gallbladder (MSG) is a rare congenital gallbladder anomaly. Between 1963 and June 2021, only 56 cases were reported. There is currently no treatment guideline for pediatric or adult cases of MSG.

PATIENT CONCERNS

A 14-year-old woman visited our out-patient clinic in September 2020 for epigastric pain that last for 6 months. Honeycomb appearance of the gallbladder was noted under ultrasonography.

DIAGNOSIS

The patient was diagnosed with MSG. The diagnosis was confirmed through computed tomography and magnetic resonance cholangiopancreatography.

INTERVENTIONS

Cholecystectomy was performed.

OUTCOMES

Epigastric pain showed limited improvement after the surgery. Since she was diagnosed with gastritis at the same time, a proton-pump inhibitor was prescribed. Epigastric pain was eventually resolved.

LESSONS

MSG cases can undergo cholecystectomy and show good recovery without complications. However, concomitant treatment may be required to resolve in the presence of other symptoms such as epigastric pain.

Understanding multiseptated gallbladder: A systematic analysis with a case report

Multiseptated gallbladder (MSG) (also known as “Honeycomb gallbladder”) is a rare condition that was first described by Knetsch in 1952, and there are around 150 cases described over the world. MSG has been described as a congenital anomaly in most of the cases and as acquired in a few. Moreover, the phenomenon was described with a variety of different symptoms and management. The aim of this article is to have better understanding of this condition and management approach. We are reporting a 4‐year‐old girl, who presented to Sidra Medicine, Qatar with MSG. We have also included 97 cases for review and analysis. The median age of presentation of the condition was 27 years but may present in neonates and in the elderly, while gender was not a risk factor. Abdominal pain is the most common presenting symptom, but it can present without symptoms. Certain congenital anomalies were detected in the pancreaticobiliary system in few patients with MSG. Medical treatment was reported in eight symptomatic patients, four of whom failed therapy. Cholecystectomy was performed in 40 patients, which resulted in resolutions of symptoms in 13 of them. Based on the available literature, congenital MSG is probably due to in‐pouching of gallbladder wall to its own cavity forming septa containing muscular fibers. MSG can be diagnosed solely via imaging, and ultrasound appears to be an effective and feasible mode of diagnosis. Medical treatment efficacy is not well‐known, but cholecystectomy has resulted in complete resolution in symptomatic patients.

Honeycomb gallbladder: a very rare cause of right upper quadrant pain

Honeycomb gallbladder is a rare congenital malformation of the gallbladder. In some cases, it may be asymptomatic, whereas in others, it may lead to symptoms consistent with biliary colic even in the absence of cholelithiasis. We present the clinical and imaging findings of a case of a 10-year-old boy who was admitted to the emergency department with right upper quadrant pain. Ultrasonography and magnetic resonance imaging showed a honeycomb gallbladder. Honeycomb gallbladder is safely diagnosed with ultrasonography, which should be part of the investigation of patients with right upper quadrant pain in the emergency department.

Multiseptate gallbladder: clinical and ultrasonographic follow-up for 12 years

There are only a few cases in literature in which a patient with multiseptate gallbladder (MSG) has been followed-up after the diagnosis. A pediatric patient with MSG has been followed-up until adulthood. Diagnosis was made at 10 years after an episode of abdominal pain. Ultrasonography showed a gallbladder with many internal septa, without stones or signs of cholecystitis. Laboratory tests were normal. Symptoms receded in a few days, and it was decided to follow the patient's course. Additional painful episodes occurred at 19 and 22 years. No changes in ultrasonographic findings were observed. MR cholangiography confirmed MSG and ruled out associated biliary ducts anomalies. Although symptomatic patients with MSG have pain relief after cholecystectomy, patients without severe biliary symptoms and without stones probably do not need immediate surgical treatment.

Diagnosis and treatment of multiseptate gallbladder with recurrent abdominal pain

Laparoscopic cholecystectomy is usually performed for gallstones or polyp of the gallbladder. Multiseptate gallbladder is a rare congenital malformation. Although several asymptomatic cases have been described, patient usually present with right upper abdominal pain. We present a 29-year-old female patient with multiseptate gallbladder, cholecystectomy was performed, and her abdominal pain and gastrointestinal complaints have resolved.