Agenesis of the gallbladder: Difficulties in management

Abstract

Gallbladder agenesis is a rare congenital biliary anomaly that may be associated with other biliary and extrabiliary congenital anomalies. Awareness of this entity by clinicians and radiologists is essential because many of these patients present with biliary symptoms and have unnecessary operations. In the present article, the relative epidemiological, etiological (embryology and development), pathophysiological, diagnostic tools and pitfalls and management aspects of this rare anatomic anomaly are briefly discussed through review of the literature. Particular reference to the difficulty in preoperative diagnosis is highlighted. The importance of the possibility of preoperative diagnosis to avoid unnecessary surgery is stressed.

Isolated Gall Bladder Agenesis – A Rare Case

“…In the first stage, the gallbladder is a hollow organ, even if the proliferation of its epithelium determines a phase in which its cavity is temporarily conceled; subsequently, through the vacuolation of its epithelium, it again becomes a hollow organ. (3) Failure of this developmental process at any stage results in agenesis of the gallbladder, whereas inappropriate migration of the gallbladder primordium will result in an ectopic gallbladder. Potential sites of ectopic gallbladder are intrahepatic, left-sided, beneath the posterior inferior surface of liver, between the leaves of the lesser omentum, within the falciform ligament, retroperitoneal, retrohepatic, or in the retropancreatic and retroduodenal areas.…”

A Choledochal Cyst Resulting In Obstructive Jaundice In A Case With Gallbladder Agenesis: Report Of A Case And Review Of The Literature

“…We determined similarly a AGB coexisting with CC in a patient who underwent surgery for obstructive jaundice. If the diagnosis of AGB is made during surgery, the surgeon must prove AGB by thoroughly examining the most common sites for ectopic gallbladder, which are intrahepatic, retrohepatic, on the left side, within the leaves of the lesser omentum or within the falciform ligament, retroduodenal, retropancreatic and retroperitoneal (9).…”

Agenesis of the gallbladder as a rare misdiagnosis

“…However, it has been reported that patients with gallbladder agenesis will have at least one symptom suggestive of biliary tract disease during their lifetime, and bile duct stones will be found in 25% to 60% of these cases [6]. The symptoms and the increased frequency of gallstones has been attributed by some authors to biliary dyskinesia [7] and compared by others to a postcholecystectomy syndrome [8,9]. Choledocholithiasis has been reported to occur in approximately 18% to 50% of patients with gallbladder agenesis and invariably presents as jaundice [10].…”