case_images: PMC11772262_01
case_images: (A) Upon the child's first hospital admission, an abdominal ultrasound revealed a linear hypoechoic area in the body of the gallbladder, with thickening and edema of the walls at the body and base; (B) An abdominal CT scan showed a rough and thickened gallbladder wall, fluid accumulation in the gallbladder fossa, and a small amount of pelvic effusion; (C) abdominal ultrasound demonstrated a linear hypoechoic area in the body, with significant thickening of the walls at the body and base, and blood flow signals were detectable within the hypoechoic region. (D) During the child's second hospital admission, abdominal ultrasound showed a marked enlargement of the base and body of the gallbladder, with pronounced thickening of the walls, and a whirlpool-like hyperechoic area was observed between them; (E) Abdominal MRI combined with MRCP indicated an enlarged gallbladder, with a "figure of eight sign" at the middle part of the body, the gallbladder wall was significantly thickened and rough, and fluid was visible in the gallbladder fossa; (F) Intraoperative findings revealed a markedly enlarged gallbladder base, with significant edema and thickening of the wall, and torsion of the body. (G and H) chronic cholecystitis associated with GT.
case_images: fped-12-1506506-g003.jpg
case_images: PMC11772262_01_fped-12-1506506-g003.jpg
case_images: F3
case_images: Ultrasonographic findings indicated gallbladder enlargement, wall edema, and thickening, along with a linear hypoechoic region in the gallbladder body, indicative of GT or vascular compression (Figures 3A). Abdominal CT scan revealed a coarse and thickened gallbladder wall, associated with fluid accumulation in the gallbladder fossa and minimal pelvic effusion (Figure 3B). By the fourth day of hospitalization, complete blood count, C-reactive protein, biochemical tests, and serum amylase levels were within the normal range; however, the B-ultrasound continued to show a linear hypoechoic area within the gallbladder body, with detectable blood flow signals (Figure 3C). Swirling hyperechoic areas were observed between the bottom and body, indicating GT (Figure 3D). The gallbladder wall was markedly thickened and rough, with fluid accumulation in the gallbladder fossa, indicating GT (Figure 3E). Intraoperative exploration showed that the gallbladder neck and cystic duct are fixed by the mesentery, while the body of the gallbladder lacks mesenteric fixation to the inferior surface of the liver, leading to a free-floating condition within the gallbladder fossa (Figure 3F). Post-surgical pathology revealed chronic cholecystitis associated with GT (Figures 3G,H).