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Case Reports
. 2018 Apr 4;13(3):640-643.
doi: 10.1016/j.radcr.2018.03.002. eCollection 2018 Jun.

Gallbladder agenesis mimicking cholelithiasis in an adult

Andrew M Moon  1 , J Hamilton Howe  2 , Katrina A McGinty  2 , David A Gerber  3   4
Affiliations
Case Reports

Gallbladder agenesis mimicking cholelithiasis in an adult

Andrew M Moon et al. Radiol Case Rep. .

Abstract

We present the case of a 24-year-old woman with morbid obesity who came to the emergency department with right upper quadrant abdominal pain associated with nausea and vomiting. Her workup included a right upper quadrant ultrasound suggestive of a small gallbladder with cholelithiasis without sonographic evidence of acute cholecystitis. She underwent attempted laparoscopic cholecystectomy with no identifiable gallbladder during surgery. Postsurgical cross-sectional imaging confirmed gallbladder agenesis. This case provides an example of a rare but convincing clinical and radiologic mimic of cholelithiasis. In certain cases of biliary colic and imaging revealing a small gallbladder, a magnetic resonance cholangiopancreatography may be warranted to evaluate gallbladder agenesis and avoid unnecessary surgery.

Keywords: Cholelithiasis; Gallbladder agenesis; Magnetic resonance cholangiopancreatography; Ultrasound.

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Figures

Fig. 1
Fig. 1
Right upper quadrant ultrasound read as a 2-mm gallbladder wall and echogenic gallstones without pericholecystic fluid, Murphy's sign, or common bile duct (CBD) dilation (3-mm CBD).
Fig. 2
Fig. 2
Axial view of computed tomography scan of abdomen and pelvis with contrast showing a small 9-mm structure in the gallbladder fossa likely related to gallbladder agenesis with no biliary obstruction and normal hepatic anatomy.
Fig. 3
Fig. 3
Coronal views of computed tomography scan of abdomen and pelvis with contrast showing a small 9-mm structure in the gallbladder fossa likely related to gallbladder agenesis with no biliary obstruction and normal hepatic anatomy.
Fig. 4
Fig. 4
Magnetic resonance cholangiopancreatography showing normal liver anatomy, absence of the gallbladder, no common bile duct dilation, and a 6-mm T1 hypointense tubular structure at the liver hilum, consistent with dilated cystic duct remnant.
Fig. 5
Fig. 5
Magnetic resonance cholangiopancreatography showing normal liver anatomy, absence of the gallbladder, no common bile duct dilation, and a 6-mm T1 hypointense tubular structure at the liver hilum, consistent with dilated cystic duct remnant.
See this image and copyright information in PMC

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