Multiseptate gallbladder (MSG) is a rare congenital malformation of the gallbladder. It most likely results from incomplete vacuolization of the developing gallbladder bud or persistent “wrinkling” of the gallbladder wall [1
]. There are multiple septa which give a honeycomb appearance in MSG, and these septa usually involve the lumen of the entire gallbladder whereas they are sometimes found in only a portion of the gallbladder [3
]. The causes of multiseptate appearance of the gallbladder on sonography include gallbladder diseases such as multiseptate gallbladder, hyperplastic cholecystosis, and cholecystitis [7
]. Asymptomatic patients are very rare in literature [3
], most patients present with long term abdominal symptoms such as right upper quadrant tenderness, recurrent abdominal pain, nause and vomiting, and gastrointestinal complaints. Septa are the reason of impaired motility of the gallbladder, and this causes a stasis in the bile flow, and it seems to be the reason of recurrent abdominal pain. Ultrasound (US) evaluation of the gallbladder is usually sufficient to diagnose MSG although other modalities such as computed tomography, magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiography (ERCP) have been described to establish the diagnosis. Ultrasound appearances consist of multiple linear echoes that can be seen to cross the gallbladder lumen, producing a honey-comb appearance [8
]. The combination of US and MRCP is the most useful and the least invasive methods to diagnose multiseptate gallbladder.