Agenesis of the gall bladder and cystic duct- interesting case report

Abstract

Congenital absence of gall bladder is a
very rare but well recognized congenital
abnormality, the reported incidence ranging
between 0.01 and 0.05. To our
knowledge, this is a very rare case and
all surgeons need to be aware of this unusual
occurrence to prevent inadvertent
injury to the dilated common hepatic
duct. Laparoscopic cholecystectomy was
planned on a suspected case of chronic
cholecystitis and was found to have congenital
absence of gall bladder and cystic
duct. The diagnosis was confirmed by
MRCP postoperatively . Standard investigations
for chronic cholecystitis were
misleading.Agenesis of gall bladder
should be highly suspected whenever
the gall bladder is not visualized on ultrasonography
or at laparoscopy done on
misinterpreted ultrasound. If the gall
bladder is not seen at laparoscopy, further
procedure should be avoided and
agenesis should be confirmed by a combination
of imaging modalities namely CT
scan, MRCP
, laparoscopic or endoscopic ultrasound,
and HIDA scan if available. If the gall bladder
is not visualized at preoperative ultrasound,
a combination of imaging modalities
should be used for diagnosis without recourse
to laparoscopylaprotomy.