Manabu Takano

A PEDIATRIC CASE OF LEFT SIDED GALLBLADDER PRESENTED WITH ACUTE ACALCULOUS CHOLECYSTITIS

This paper reports a pediatric case of left sided gallbladder presented with acute acalculous cholecys-titis. The patient was a 11-year-old male complaining of right upper abdominal pain and fever. High values of white blood cell count and CRP were recognized and a mass was palpable on his right upper abdomen. Ultrasonography reveaeld the findings of acute acalculous cholecystitis, and immediately percutaneous transhepatic cholecystodrainage was performed. The common bile duct was imaged at the right side of the fundus of the gallbladder by a drainage tube cholangiography. No abnormalities were found in the common bile duct. The pancreatic duct and gallbladder were invisible by ERCP. Considering of his young age, conservative therapy was started. But as soon as the drainage tube was clamped, abdominal pain and fever occurred. So cholecystectomy was performed. The operative findings indicated gangrenous cholecystitis. The cystic duct was occluded. The liver bed was found in the left to Ligamentum teres hepatis and the gallbladder located on the lateral segment. Generally speaking, the most left sided gallbladders are incidentally found during the operation for another disease. As for this case, the left sided gallbladder itself probably caused the occlusion of the cystic duct because of its unnatural run.