Epehólyag-agenesia. Epekövességet utánzó ritka rendellenesség egy felnőtt nőben

Abstract

Gallbladder agenesis is a rare congenital malformation due to an embryological defect of the biliary system. In most cases it is asymptomatic, but it can also mimic biliary colic. We report the case of a 72-year-old Caucasian woman with a medical history of cardiovascular disease and hypercholesterolemia, under cholesterol-lowering and hypotensive treatment, who presented symptoms suggesting biliary colic. She underwent laparoscopic surgery that confirmed the final diagnosis. We present our approach in this rare case as well as a brief review of medical literature. The surgeon should decide intraoperatively whether to continue and search for a possible ectopic gallbladder or investigate further with imaging studies. Gallbladder agenesis is a rare condition that the surgeon must be aware of. In the cases of inconclusive or indirect signs of cholelithiasis, the best approach is complementary imaging investigations such as magnetic resonance cholangiopancreatography in order to avoid surgery. Orv Hetil. 2019; 160(38): 1510–1513.

Gallbladder Agenesis: Report of a Preoperative Diagnosis With Magnetic Resonance Cholangiopancreatography

“…This clinical presentation could be linked to a concomitant biliary disease, such as stones or dyskinesia, due to a significantly augmented sphincter of Oddi resting pressure, which leads to regurgitation of pancreatic or duodenal contents. It may also be caused by a condition unrelated to biliary tract diseases such as duodenitis, esophagitis, gastritis, or irritable bowel disease [7].…”

“…Clinicians should keep GA on their differential diagnosis list, and imaging modalities, such as MRCP, should be obtained when other tests prove inconclusive. In fact, MRCP is considered the test of choice if there is suspicion of GA, and it is also helpful in demonstrating other possible anomalies of the biliary tract [3,5,7].…”