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Case Reports
. 2024 Jul 27;16(7):e65490.
doi: 10.7759/cureus.65490. eCollection 2024 Jul.

Unaccounted Gallbladder

Sunil Vishwakarma  1 , Chhavindar Singh  1 , Tripti Agarwal  1 , Aditya Sagar  1
Affiliations
Case Reports

Unaccounted Gallbladder

Sunil Vishwakarma et al. Cureus. .

Abstract

Gallbladder agenesis is a rare anatomical variant, and most cases are asymptomatic and diagnosed on autopsy. Few of them may present with features suggestive of biliary tract pathology. A 32-year-old male presented with complaints of intermittent epigastric pain for three months. Abdominal ultrasonography was suggestive of chronic calculous cholecystitis, and he was planned for laparoscopic cholecystectomy. However, no gallbladder was found during the surgery. Postoperative evaluation was suggestive of an absent gallbladder with a normal ductal system. A provisional diagnosis of sphincter of Oddi dysfunction was made based on his symptoms. Congenital absence of gallbladder is a rare anomaly and only a few of the affected individuals are symptomatic. Lack of specific features, coupled with the inability of standard abdominal ultrasonography to detect the absence of gallbladder, can put the treating surgeon in a dilemma intraoperatively. Agenesis of the gallbladder is often missed and this entity should be kept in mind while having difficulty in visualizing the gallbladder. An astute surgeon should be wary of this diagnosis during difficult dissection to avoid bile duct injuries.

Keywords: acalculous cholecystitis; acute calculous cholecystitis; agenesis of gall bladder; cancer gall bladder; choledocholithiasis; cholelithiasis; chronic calculous cholecystitis; gall bladder dysmotility; pancreatitis; sphincter of oddi.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Pre-operative ultrasound abdomen showing normal common bile duct
Figure 2
Figure 2. Intra-operative image revealing the absence of gallbladder. The markings labelled are enlisted as: 1. Right lobe of liver, 2. Caudate lobe of liver, 3. Common bile duct, and 4. Rouviere's sulcus.
Figure 3
Figure 3. Magnetic resonance cholangiopancreatography - axial section image (done in postoperative period) - showing normal common bile duct but absence of gallbladder and cystic duct.
Figure 4
Figure 4. Magnetic resonance cholangiopancreatography - coronal section image - showing normal common bile duct and absence of gallbladder and cystic duct.
See this image and copyright information in PMC

References

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