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Case Reports
. 2011 Sep;5(3):654-62.
doi: 10.1159/000334988. Epub 2011 Dec 2.

Gallbladder agenesis

Pashtoon Murtaza Kasi  1 , Raymund Ramirez, Shari S Rogal, Kailey Littleton, Kenneth E Fasanella
Affiliations
Case Reports

Gallbladder agenesis

Pashtoon Murtaza Kasi et al. Case Rep Gastroenterol. 2011 Sep.

Abstract

Gallbladder agenesis is a rare entity with an estimated incidence of 10-65 per 100,000. Females are more commonly affected (ratio 3:1), typically presenting in the 2nd or 3rd decade of life. Despite an absent gallbladder, half of patients present with symptoms similar to biliary colic, which is poorly understood. Clinicians should have a strong index of suspicion if nonvisualization is suggested by an ultrasound. HIDA scans are typically not helpful since nonvisualization of the gallbladder remains typical of cystic duct obstruction as well as of agenesis. While there are no specific guidelines for management of gallbladder agenesis, conservative management with smooth muscle relaxants is preferred. Sphincterotomy also has been reported in severe cases. Here, we report a case of a 21-year-old woman who presented with recurrent biliary colic and was diagnosed to have gallbladder agenesis on magnetic resonance cholangiopancreatography. A comparison with other cases and a review of the literature are presented.

Keywords: Biliary colic; Conservative management; Gallbladder agenesis; Magnetic resonance cholangiopancreatography; Sphincterotomy.

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Figures

Fig. 1
Fig. 1
MRCP showing a 4-mm cystic lesion adjacent to the proximal common hepatic duct with apparent communication through a tiny duct with the right hepatic duct, representing a hypoplastic gallbladder. MRCP is considered the test of choice if there is suspicion of a hypoplastic gallbladder. It is also helpful in demonstrating an ectopic gallbladder along with other possible anomalies of the biliary tract system.
Fig. 2
Fig. 2
Algorithm for workup and management of gallbladder agenesis as suggested by Malde [2]. As noted, while there are no specific guidelines for management of gallbladder agenesis, conservative management with smooth muscle relaxants is preferred. Sphincterotomy also has been reported in severe cases. (Permission to use under creative contributions open access license from http://www.biomedcentral.com; permission also obtained from the author.)
See this image and copyright information in PMC

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