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Related Experiment Videos

Duplicate gallbladder cholecystitis after open cholecystectomy.

T Shapiro1, W Rennie

  • 1Long Island Jewish Medical Center, New Hyde Park, NY, USA. RTShap@aol.com

Annals of Emergency Medicine
|April 27, 1999
PubMed
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A patient experienced severe abdominal pain after gallbladder removal, only to be diagnosed with a second gallbladder requiring another surgery. This case highlights the importance of considering rare congenital biliary anomalies in post-cholecystectomy pain.

Area of Science:

  • Gastroenterology and Hepatobiliary Surgery
  • Surgical Case Reports
  • Medical Diagnostics

Background:

  • Post-cholecystectomy syndrome (PCS) is a common cause of persistent abdominal pain after gallbladder removal.
  • The differential diagnosis for right upper quadrant pain post-surgery is broad, often including functional disorders or retained stones.
  • Congenital biliary anomalies are infrequently considered in the post-operative setting.

Observation:

  • A 42-year-old male presented with acute right upper quadrant pain two years after an open cholecystectomy.
  • Diagnostic evaluation revealed acute cholecystitis in a previously undiagnosed second gallbladder.
  • The patient underwent a second cholecystectomy for the symptomatic accessory gallbladder.

Findings:

  • The presence of a second, symptomatic gallbladder can mimic or complicate the diagnosis of post-cholecystectomy syndrome.

Related Experiment Videos

  • Congenital duplication of the gallbladder, though rare, is a potential cause of recurrent biliary pain.
  • Accurate diagnosis requires thorough evaluation, including advanced imaging, to identify all biliary structures.

    • Implications:

    • Emergency physicians and surgeons must maintain a high index of suspicion for uncommon biliary anomalies in patients with refractory post-cholecystectomy pain.
    • Recognition of congenital biliary abnormalities is crucial for appropriate management and preventing misdiagnosis of PCS.
    • This case underscores the need to consider anatomical variations in the biliary system when standard diagnoses do not fit.