Gallbladder Hypoplasia, a Congenital Abnormality of the Gallbladder: A Case Report

Abstract

Patient: Male, 62Final Diagnosis: Gallbladder hypoplasiaSymptoms: Abdominal painMedication: —Clinical Procedure: —Specialty: SurgeryObjective:Congenital defects/diseasesBackground:There are different variations in the anatomy of the gallbladder. Congenital abnormalities of the gallbladder such as agenesis and hypoplasia are rare conditions and difficult to diagnose with imaging studies. Patients are usually asymptomatic or have symptoms that mimic gallstone disease. The diagnosis is often made intraoperatively and is established by histopathological examination.Case Report:We report a case of a 62-year-old male who had cholelithiasis symptoms and was falsely diagnosed with gallstone disease by abdominal ultrasound scan. The patient underwent an operation which revealed a rudimentary gallbladder. The histology result showed hypoplastic gallbladder tissue.Conclusions:This case suggests that surgeons need to take into consideration congenital anomalies of the gallbladder intraoperatively in order to avoid any iatrogenic injury to biliary tract during a routine laparoscopic cholecystectomy. Intraoperative cholangiography can be a useful tool to avoid unnecessary surgical risky interventions.

Micro-gallbladder: A rare surgical problem

“…Micro-gallbladder is associated with CF and rarely with other conditions like a-1 antitrypsin deficiency, idiopathic neonatal hepatitis and biliary atresia. [1][2][3][4] Up to one-third of patients with CF have gallbladderrelated abnormalities. [1][2][3] Chronic calculous cholecystitis may also cause recurrent inflammation and severe fibrosis resulting in atrophy of gallbladder.…”

“…[1][2][3][4] Up to one-third of patients with CF have gallbladderrelated abnormalities. [1][2][3] Chronic calculous cholecystitis may also cause recurrent inflammation and severe fibrosis resulting in atrophy of gallbladder. Non-visualisation of the gallbladder on initial ultrasound scan raised the suspicion of agenesis or intrahepatic gallbladder; thus an MRCP was carried out to better visualise the biliary tree.…”

Recurrent pancreatitis in the setting of gallbladder agenesis, ansa pancreatica, Santorinicoele and eventual intraductal papillary mucinous neoplasia (IPMN)

“…5 In the general population, the incidence of gallbladder agenesis ranges between 0.01% to 0.065% with women three times more likely to be affected than men. 6 With variable clinical presentations observed with gallbladder agenesis, Bennion et al 7 classified the disorder into three categories of which 50% are symptomatic, 35% are asymptomatic, and 15% are associated with congenital anomalies such as renal agenesis, pancreatic divisum, duodenal atresia, imperforate anus, and cardiac septal defects.…”

Microgallbladder: Self-Remitting Acute Cholecystitis-Like Condition Unique to Patients with Cystic Fibrosis

“…In a cohort study by Dietrich et al (2002) of 72 patients with cystic fibrosis and 60 healthy subjects using the aforementioned ultrasound exclusion criteria, the incidence of microgallbladder was 25% (18/72) in patients with cystic fibrosis, versus 0% (0/60) in healthy individuals, which is in lieu of prior literature reports of microgallbladder incidence of 5–45% in patients with CF [10, 12, 15, 17, 18]. In addition to the imaging diagnostic criteria, the diagnosis of microgallbladder has to be taken in clinical context of known history of recurrent bouts of acute cholecystitis-like symptoms, due to the prevalence of microgallbladder mimickers in patients with CF and animal models with CFTR gene mutation, such as congenital gallbladder hypoplasia, gallbladder agenesis, and biliary atresia [1, 4, 19, 20].…”