15 yrs old, persistent ruq abd pain, vomiting when eating, and weight loss x4mos. hida 100% eject. fraction. no stones. gas. eosinophils found only (lvl 3) on steroids. could it still be gallbladder?

Yes: Supra normal (> 90%) gbef have been reported in scientific literature, esp in celiacs, d/t super sensitive to cck (hormone that stimulates gallbadder to empty w/ meals ; given intravenously during hida scan to measure gbef). In my professional experience ; supported by science such a high gbef w/ symptoms can be associated w/ diseased gb ; a favorable response to surgery. Ask surgeon w experience.

Yes: This could still be gallbladder related. Some surgeons are comfortable proceeding with a diagnostic laparoscopy for unexplained RUQ pain in this setting and will remove the gallbladder if it appears abnormal.

RUQ Pain: Have you seen a pediatric gastroenterologist? This would be the best next step as there are still a number of other possibilities. Sounds like you had a hida scan but have you had ultrasound (us)? Has your pancreas and liver been evaluated by lab measurements or us? Being evaluated by the best trained physician in the age disease group is always best.

Hyperkinetic gb?: Most physicians in nuclear medicine and gastroenterology believe that increased ejection fraction of gall bladder is probably normal (above 35%, 50% in children). A well known nuclear physician reported small group of patients with hyperkinetic gall bladder getting relief with removal of gb. More studies needed to convince most surgeons. Surgeon may not be willing to operate with normal study.