Symptomatic cholelithiasis in an ectopic retrocolic retroduodenal subhepatic duplicated gallbladder

Gallbladder duplication is a rare anatomic variant of biliary anatomy, which can present diagnostic and treatment challenges. In this case, a 49-year-old male presented with classic symptoms of biliary colic to his primary care physician, and while computed tomography (CT) noted the presence of gallstones, neither CT nor ultrasound was able to locate a gallbladder within the gallbladder fossa. Initial surgery found and cauterized a rudimentary gallbladder, but symptoms persisted, requiring a second surgery and secondary analysis of CT, ultrasound, and magnetic resonance imaging with magnetic resonance cholangiopancreatography. Imaging helped clarify the diagnosis of gallbladder duplication (ductular type), where the first gallbladder's cystic duct inserted high on the common hepatic duct, and the second retroplaced gallbladder's cystic duct inserted into the midportion of the common bile duct. Thorough understanding of the numerous gallbladder duplication variants, careful interpretation of modern imaging, and close collaboration between surgeon and radiologist are essential for optimal management of patients with gallbladder duplications.