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Agenesis of the gallbladder.

U Baltazar¹, J Dunn, S Gonzalez-Diaz

¹Department of Surgery, Hospital General de la Ciudad de Mexico SSA, Mexico City.

Southern Medical Journal

|September 27, 2000

Summary

Agenesis of the gallbladder, a rare condition, presents with right upper quadrant pain. Surgical exploration is crucial for diagnosis when the gallbladder is not found during surgery.

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Area of Science:

Gastroenterology
Surgical Anatomy

Background:

Gallbladder agenesis is a rare congenital anomaly.
It is typically categorized into three groups: those with multiple fetal anomalies, asymptomatic cases, and symptomatic cases.

Observation:

A 72-year-old woman presented with right upper quadrant pain, nausea, and vomiting, consistent with symptomatic gallbladder agenesis.
Physical examination revealed right upper quadrant tenderness, elevated white blood cell count (10,300/mm3), and a total bilirubin level of 1.6 mg/dL.
Initial ultrasonography suggested a gallstone and an enlarged common bile duct, complicating the diagnostic picture.

Findings:

Laparoscopic cholecystectomy was converted to an open procedure due to the inability to locate the gallbladder.
Intraoperative cholangiography confirmed the absence of the gallbladder, establishing the diagnosis of gallbladder agenesis.
A T-tube was placed following the procedure.

Implications:

This case highlights the importance of considering gallbladder agenesis in the differential diagnosis of right upper quadrant pain, especially when standard imaging is inconclusive.
Thorough intraoperative exploration and cholangiography are essential for confirming the diagnosis and guiding surgical management.
Accurate diagnosis and management are critical to prevent potential complications associated with undiagnosed gallbladder agenesis.

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