Multiseptate gallbladder in an asymptomatic 7-month-old girl

Clinical History

An asymptomatic 7-month-old girl underwent an abdominal ultrasound for
suspected mild hepatomegaly.

Imaging Findings

The only abnormality detected was the appearance of a cystic mass with multiple septations in the expected location of the gallbladder. A normal gallbladder could not be demonstrated in any other location.
There were no other cystic lesions in the liver and the bile ducts demonstrated normal morphology. The finding was considered as probably incidental and a presumptive diagnosis of multiseptate gallbladder was made.
This initial diagnosis was confirmed quite easily by repeating the ultrasound after bottle-feeding the baby. Thirty minutes after feeding, the cystic mass had reduced notably in size.

Discussion

Multiseptate gallbladder is an unusual congenital malformation first described in 1963 by Simon and Tandon [1]. Some of the reported patients were described as having recurrent episodes of abdominal colic pain, while others remained asymptomatic [2, 3]. There is not enough evidence to support a concern of an eventual malignant potential. Typically, asymptomatic patients are managed conservatively, while those with episodes of pain or jaundice undergo cholecystectomy. In some of the few reported cases, diagnosis was confirmed with MRCP, CT, or cholecystography. To our knowledge, this is the first instance of postprandial ultrasound being performed to diagnose a case of multiseptate gallbladder. We believe it is an immediate, safe, and reliable method to confirm the diagnosis. Virtually every other hepatic cystic lesion, which could be included in the differential diagnosis, would remain unchanged after feeding. This patient was managed conservatively. One year after the initial diagnosis, she remains healthy, without any changes upon ultrasound examination.

Differential Diagnosis List

Final Diagnosis

Multiseptate gallbladder

URL:	https://www.eurorad.org/case/12560
DOI:	10.1594/EURORAD/CASE.12560
ISSN:	1563-4086