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Congenital absence of the gallbladder: ways of avoiding laparotomy
J A Akoh1, M M George, C D Auld
1Dumfries and Galloway Royal Infirmary.
Insights
Congenital gallbladder agenesis is rare. This study presents two cases, one with cholangitis and another with abdominal pain, highlighting diagnostic challenges and the potential role of laparoscopy.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Medical Diagnostics
Background:
- Congenital gallbladder agenesis is a rare anomaly.
- It can present with varied clinical symptoms or be asymptomatic.
- Accurate diagnosis is crucial for appropriate patient management.
Observation:
- Two cases of gallbladder agenesis were identified over five years.
- Case 1: Ascending cholangitis secondary to choledocholithiasis.
- Case 2: Right upper quadrant pain with inconclusive imaging (ultrasound, oral cholecystography).
Findings:
- Diagnosis was confirmed intraoperatively via laparotomy in both instances.
- Laparoscopy may offer a less invasive approach for diagnosing this anomaly.
- Challenges in preoperative diagnosis due to non-specific symptoms and imaging findings.
Implications:
- Laparoscopic techniques could improve diagnostic accuracy and reduce surgical intervention for gallbladder agenesis.
- Increased awareness of this rare condition is needed among clinicians.
- Further research into minimally invasive diagnostic methods is warranted.
Abstract:
Two cases of congenital absence (agenesis) of the gallbladder seen at one hospital over a 5-year period are presented. One patient presented with ascending cholangitis due to choledocholithiasis, while the other presented with right upper quadrant abdominal pain and equivocal findings on ultrasound and oral cholecystography. Although diagnosis was made at laparotomy in both cases, it is likely that the arrival of laparoscopic cholecystectomy will avoid laparotomy in the future. The place of laparoscopy in establishing the presence of this anomaly is discussed.