Gallbladder agenesis and cystic duct absence in an adult patient diagnosed by magnetic resonance cholangiography: report of a case and review of the literature

Abstract

Gallbladder agenesis (GA) is a rare congenital anomaly of the biliary system often associated with other congenital abnormalities. Patients become symptomatic in 23% of cases. GA is often misinterpreted as other diseases, therefore, leading to unnecessary surgery. We report a case of congenital GA associated to cystic duct absence and a biliary tract abnormality diagnosed by Magnetic Resonance with Cholangiopancreatography.

Figure 1

Ultrasonography scan demonstrates an hyperechoic area with an acoustic shadow in the gallbladder fosse (arrow). These findings usually are suspected for sclero-atrophic or contracted lithiasic gallbladder.

Figure 2

Transverse T2-weighted TSE sequences (up) and Coronal BALANCE sequences (down) do not visualize the gallbladder in the cholecystic fossa.

Figure 3

3D-MIP breath-hold acquisition of a single slice in the coronal plane demonstrates the absence of both the gallbladder and the cystic duct or an ectopic gallbladder. The intrahepatic bile ducts appear normal with no images of stenosis or repletion defects. The hepatocholedocho is visualized until the second part of the duodenum, in correspondence to the Major papilla. Also the Wirsung duct demonstrates an anatomical variation; it is visualized until the initial part of the duodenum, in correspondence to the Minor papilla.