Gallbladder dyskinesia seems to be an increasingly more common diagnosis being seen in the surgeons office in recent years, particularly with the advent of nuclear medicine hepatobiliary cholangiography and the use of CCK to calculate the GB ejection fractions. Most of these cases, however, are adults, usually age 20-50. Recently, I saw a 10 year old 75 lb girl with "classic" post-prandial biliary symptoms and a CCK-DISIDA scan demonstrating a GB ejection fractions of 0% and 34% on the low and high dose CCK, respectively. Her only "significant" past medical history is that of dermatomyositis for the past 2-3 years, previously treated with prednisone, but with only Plaquinel over the past year. I checked with the company that manufactures this medication and according to them GB dyskinesia is not one of the reported adverse reactions. Work-up has included: UGI-negative; nuclear med reflux study demonstrating 2 episodes of mild reflux over a 30 minute period. She hads had no improvement in her symptoms despite Tagamet therapy.
Any suggestions, other than eventually proceeding with a laparoscopic cholecystectomy?