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CASE REPORT article

Front. Pediatr.

Sec. Pediatric Surgery

Volume 13 - 2025 | doi: 10.3389/fped.2025.1548318

This article is part of the Research Topic Novel targets in pediatrics: advances in diagnostic and therapeutic approaches View all 5 articles

Laparoscopic Appendectomy and Cholecystectomy in a 2-Year-Old with Acute Suppurative Appendicitis and Gallbladder Torsion: A Case Report

Provisionally accepted
  • Huai'an Maternity and Child Health Care Hospital, Huai'an, China

The final, formatted version of the article will be published soon.

    Background: Pediatric gallbladder torsion is a rare but potentially life-threatening cause of acute abdomen [1] . The first case was reported in the 19th century, yet the precise pathogenesis remains unclear [2] . Due to its nonspecific symptoms, gallbladder torsion in children is frequently misdiagnosed as more common conditions, such as acute appendicitis, cholecystitis, or gastrointestinal infections [3] .Case Presentation: A 2-year and 4-month-old boy was admitted to our emergency department with abdominal pain, fever, and vomiting. Initial blood tests revealed a white blood cell count of 13.13 × 10^9/L, neutrophil percentage at 76.1%, and an absolute neutrophil count of 9.99 × 10^9/L. Abdominal CT indicated thickened gallbladder walls, a partially blurred appendix margin, an intraluminal dense shadow, and multiple enlarged lymph nodes, along with pelvic effusion. A diagnosis of acute appendicitis was made. Emergency laparoscopy showed a suppurative appendix, leading to an appendectomy. Further inspection revealed a 360° counterclockwise torsion of the gallbladder neck with necrosis and black discoloration, without perforation. A laparoscopic cholecystectomy was performed. Nine days postoperatively, the child developed symptoms of an upper respiratory tract infection, necessitating transfer to the pediatric respiratory department, and was discharged on postoperative day 19 with no complications.Laparoscopic exploration for pediatric acute appendicitis should include the gallbladder as a standard investigation target.

    Keywords: Appendectomy, Appendicitis, Cholecystectomy, Gallbladder torsion, Laparoscopy

    Received: 19 Dec 2024; Accepted: 24 Mar 2025.

    Copyright: © 2025 Sun, Zhang and Gu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Chunhui Gu, Huai'an Maternity and Child Health Care Hospital, Huai'an, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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