A case of an absent gall bladder presenting as biliary colic in a tertiary care hospital in Karachi

J Pak Med Assoc. 2019 May;69(5):731-733.

Abstract

Gallbladder agenesis is a rare congenital anomaly occurring in 10-65 per 100,000 populations with the incidence being more common in females with a ratio of 3:1. Although asymptomatic, some patients present with symptoms like biliary colic and often indistinguishable from common conditions leading to unnecessary surgery. A 19-year old woman presented to the hospital with epigastric and right upper quadrant pain, other signs and symptoms consistent with biliary colic. However, on laparoscopy gall bladder was absent. Ultra-sound of the abdomen is the preferred for gallbladder diseases but due to scarcity of reports on gallbladder agenesis, it is often misread due to periportal tissue and sub-phrenic folds often reported as gallbladder or calculi leading to unnecessary surgery. Agenesis, a rare anomaly, poses a diagnostic dilemma to surgeons as it is usually diagnosed during a laparoscopic cholecystectomy. Clinicians should keep in mind this entity when the gallbladder is poorly visualized on ultrasound and think of more detailed investigations such as Magnetic resonance cholangiopancreatography.

Keywords: Gallbladder Agenesis, Congenital Anomaly, Bilary Colic, Laparoscopic Surgery, Karachi..

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Cholecystectomy, Laparoscopic
  • Cholecystitis / diagnosis
  • Cholecystitis / surgery
  • Chronic Disease
  • Diagnostic Errors
  • Dietary Fats
  • Digestive System Abnormalities / complications
  • Digestive System Abnormalities / diagnosis*
  • Female
  • Food Intolerance / etiology
  • Gallbladder / abnormalities*
  • Humans
  • Nausea / etiology
  • Vomiting / etiology
  • Young Adult

Substances

  • Dietary Fats