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Agenesis of gall bladder in laparoscopic cholecystectomy-A case report
Samer Makki Mohamed Al-Hakkak1
1Department of Surgery, Faculty of Medicine, Jabir Ibn Hayyan Medical University, Najaf city, Iraq.
Insights
Gallbladder agenesis is a rare congenital condition. Patients may present with gallstone-like symptoms, highlighting the need for careful diagnosis to avoid unnecessary surgery.
Area of Science:
- Gastroenterology
- Congenital Anomalies
- Biliary System Imaging
Background:
- Gallbladder agenesis is a rare congenital anomaly.
- It can be associated with other biliary and extra-biliary anomalies.
Purpose of the Study:
- To highlight the diagnostic challenges of gallbladder agenesis.
- To emphasize the importance of accurate imaging in diagnosing biliary tract anomalies.
Main Methods:
- Case presentation of a 43-year-old female with upper abdominal pain.
- Initial diagnosis considered gallstone disease based on symptoms and ultrasound.
- Laparoscopic exploration revealed absent gallbladder.
Main Results:
- Symptomatic gallstones can mimic or coexist with gallbladder agenesis.
- Ultrasound is a key diagnostic tool but requires expert interpretation.
- Accurate diagnosis is crucial to prevent unnecessary surgical interventions.
Conclusions:
- Gallbladder agenesis should be considered when the gallbladder is not visualized.
- Relying solely on ultrasound may lead to misdiagnosis; multiple expert opinions are advised.
- Awareness among clinicians, surgeons, and radiologists is essential to avoid risky exploratory surgeries.
Introduction:
Agenesis of gallbladder is a rare congenital anomaly of biliary tree that may be associated with other biliary and extra biliary congenital anomalies.
Case Presentation:
A 43- year- old female presented with a 4 months history of upper abdominal pain associated with nausea and vomiting. It was associated with dyspeptic symptoms and become worse following ingestion of high-fat meal contents. Clinically, a differential of gall stone disease was considered. Ultrasonography of abdomen revealed a contracted gallbladder with multiple stones with normal wall thickness, so the fact of clinical diagnosis considering finding cholithiasis. She was submitted to laparoscopic exploration which revealed that the gall bladder was absent within gall bladder fossa.
Discussion:
In this case, the differential of cholithiasis symptoms considered support by ultrasonography, symptomatic gall stones presented more than half of cases of gall bladder agenesis, Diagnosis of gall bladder disease usually done by ultrasound modality, it must be done by expert one. Awareness of this entity by clinicians, surgeons and radiologists are essential because many of these patients present with biliary symptoms and have unnecessary operations.
Conclusion:
Agenesis of gallbladder should be kept in mind whenever the gall bladder was improperly visualized in routine imaging methods. Ultrasonography operated dependent we must not depend on single one or even multiple done by the same person. Avoid a needless surgical exploration, which might be risky. Non-visualized gall bladder during laparoscopic cholecystectomy is challenging should not convert to open unless sure that the gall bladder was present.
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