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

• Published in: Journal of the Pakistan Medical Association Vol. 69; no. 5; pp. 731 - 733
• Main Authors: Talib, Vikash, Khan, Anser Saeed, Dawani, Surrendar, Ahmed, Hassan
• Format: Journal Article
• Language: English
• Published: Pakistan Knowledge Bylanes 01-05-2019
• Subjects: Abdominal Pain - etiology; Agenesis; Cholecystectomy, Laparoscopic; Cholecystitis - diagnosis; Cholecystitis - surgery; Chronic Disease; Colic; Diagnostic Errors; Dietary Fats; Digestive System Abnormalities - complications; Digestive System Abnormalities - diagnosis; Dyspepsia; Embryonic development; Female; Food Intolerance - etiology; Gallbladder; Gallbladder - abnormalities; Genetic disorders; Humans; Laparoscopy; Nausea; Nausea - etiology; Surgery; Vomiting - etiology; Young Adult; Pakistan; Gallbladder Agenesis, Congenital Anomaly, Bilary Colic, Laparoscopic Surgery, Karachi
• ISSN: 0030-9982

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.