Pediatric gallbladder dyskinesia managed with laparoscopic cholecystectomy: A case report and literature review.

INTRODUCTION AND

IMPORTANCE

Gallbladder dyskinesia, also known as functional gallbladder disorder, is an uncommon cause of abdominal pain in the pediatric population, particularly in children under five years of age. It is characterized by impaired gallbladder motility in the absence of gallstones. Due to its nonspecific symptoms, diagnosis is often delayed, which may prolong morbidity.

CASE PRESENTATION: This report presents a 4-year-old boy from a rural area who was referred to our surgical clinic by his pediatrician after failed conservative management of persistent abdominal pain. He had a six-month history of worsening right hypochondrial pain, intermittent fever, anorexia, nausea, and vomiting. Examination revealed right hypochondrial tenderness, a palpable mass, and guarding. Laboratory findings demonstrated leukocytosis (15.7 × 109/L), mild anemia (Hb 11.2 g/dL), and elevated C-reactive protein (68 mg/L). In this limited-resource setting, cholescintigraphy was not available. Instead, serial abdominal ultrasound scans performed after fatty meals showed persistent gallbladder hydrops with failed contraction, correlating with right hypochondrial pain, and no evidence of gallstones and a normal biliary tract. CT scan further confirmed gallbladder distension and excluded other causes of abdominal pain. Based on these findings and persistent symptoms, biliary dyskinesia was highly suspected. The patient subsequently underwent laparoscopic cholecystectomy. The postoperative recovery was uneventful, and the patient achieved complete resolution of symptoms.

CLINICAL DISCUSSION: Gallbladder dyskinesia in children presents diagnostic challenges because of its overlap with more common gastrointestinal conditions. Imaging is essential for detecting gallbladder pathology and ruling out alternative causes. Although conservative management is usually attempted initially, persistent symptomatic cases benefit from surgical intervention. Laparoscopic cholecystectomy offers a minimally invasive, safe, and effective option with rapid recovery and durable symptom relief, even in very young children.

CONCLUSION

Gallbladder dyskinesia, while rare in children, should be considered in cases of persistent biliary-type symptoms unresponsive to conservative therapy. Laparoscopic cholecystectomy provides definitive treatment and significantly improves quality of life.