Management of an unsuspected double gall bladder

Area of Science:

• Gastroenterology and Hepatobiliary Surgery
• Congenital Anomalies
• Diagnostic Imaging

Background:

• Gall bladder duplication is an uncommon congenital anomaly.
• Often asymptomatic, leading to delayed diagnosis until surgical intervention.
• Biliary anomalies present diagnostic challenges in routine imaging.

Purpose of the Study:

• To report a case of incidentally discovered gall bladder duplication.
• To highlight the difficulties in pre-operative diagnosis of biliary anomalies.
• To emphasize the importance of intraoperative vigilance during cholecystectomy.

Main Methods:

• Case presentation of a 47-year-old female with abdominal symptoms.
• Initial imaging included ultrasound and magnetic resonance cholangiopancreatography.
• Laparoscopic cholecystectomy with intraoperative discovery and removal of duplicated gall bladders.

Main Results:

• Pre-operative imaging identified gallstones but missed gall bladder duplication.
• A double gall bladder with two cystic ducts was found during surgery.
• Histopathology confirmed chronic cholecystitis in both gall bladders.

Conclusions:

• Pre-operative diagnosis of gall bladder duplication can be challenging.
• Intraoperative awareness is crucial for identifying unexpected biliary anomalies.
• Successful laparoscopic management of duplicated gall bladders is feasible.