Hydrops of the gallbladder in children.

Gallbladder disease in children today is being diagnosed increasingly because of better awareness of its existence and of improved diagnostic capability. A case is presented to describe an unusual pathologic variant termed "acute hydrops" of the gallbladder. This entity occurs specifically in children and is characterized by an acute illness with massive distention of the gallbladder in the absence of stones, bacteria, or congenital malformations. Differential diagnoses include appendiceal abscess, intussusception, volvulus, peritonitis, and pyelonephritis. Routine and contrast radiographic techniques may be combined with abdominal ultrasound to aid in the preoperative diagnosis. The etiology of hydrops is not known, but bile stasis and mesenteric lymphadenitis seem to be important factors. Treatment has varied from supportive observation to operative aspiration or cholecystectomy.