Septate gall bladder.

A 5-year-old girl child was admitted with complaints of fever, nonbilious vomiting and anorexia. The child weighed 15.5 Kg and the height was 91 cm. On examination she had no dysmorphic features, moderate dehydration, pallor, icterus and a tender hepatomegaly of 3 cm. On investigation, the hemoglobin was 9.8 g/dl and total leukocyte count 14,500 cells/cu mm. Total bilirubin was 3.6 mg/dl with a direct fraction of 1.9 mg/dl, SGPT 272 IU/L, SGOT 198IU/L and alkaline phosphatase 338IU/ L. Serum was posiive for anti HAV IgM. The child received replacement fluids and electrolytes. An ultrasound of the abdomen was done two days later for persistant right hypochondnal pain and increased direct bilirubin of 3 mg/dl. It showed an enlarged liver with normal echotexture. The gall bladder was normal in size with a septum in between the body and fundus. This was confirmed by an endoscopic retrograde cholangiopancreatography (ERCP) (Fig. 1) which showed a normal papilla, pancreatic and hepatic ducts. The gall bladder was single and normally located with an incomplete septum. The child recovered in two weeks.