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Mohammed AA, Arif SH. Gallbladder agenesis: An accidental finding during laparotomy for hepatic tumor. Int J Surg Case Rep 2021; 82:105875. [PMID: 33857765 PMCID: PMC8065278 DOI: 10.1016/j.ijscr.2021.105875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/02/2021] [Accepted: 04/04/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Anomalies of the biliary system are frequently encountered. Agenesis of the gall bladder is a rare. The exact incidence is not known as most cases are asymptomatic and diagnosed incidentally during surgeries for unrelated conditions or at autopsy. This anomaly may occur alone or in association with other anomalies such as other biliary anomalies, portal vein anomalies and other vascular anomalies, or in some cases hepatic, gastrointestinal or anomalies in other body systems. CASE PRESENTATION An elderly man diagnoses with segment VI liver tumor and planned for surgical resection. During surgery we accidentally discovered gall bladder agenesis with slightly dilated common bile duct. The tumor resected successfully and the final diagnosis was well differentiated with hepatocellular carcinoma. CONCLUSION Careful search for the gall bladder must be done before diagnosing agenesis of the gall bladder. No conversion is required provided adequate visualization and search for the gall bladder is done during laparoscopy. Postoperative MCRP will define the biliary anatomy and to help the surgeons to have postoperative accurate decision.
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Affiliation(s)
- Ayad Ahmad Mohammed
- Department of Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq.
| | - Sardar Hassan Arif
- Department of Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq
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2
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Pessanha I, Alexandrino H, Piedade C, Cunha C, Gonçalves I, Lopes MF, Furtado E. Successful liver transplantation using a whole liver graft with gallbladder agenesis: First report in pediatric liver transplantation. Pediatr Transplant 2019; 23:e13342. [PMID: 30575232 DOI: 10.1111/petr.13342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/14/2018] [Accepted: 11/27/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Gallbladder agenesis (GA) is a rare congenital condition, occurring in approximately 40/100.000. It is likely due to an embryologic mishap in the development of the gallbladder bud and can be associated with other congenital variations in biliary anatomy. However, the liver likely suffers no functional impairment and can be safely used for transplantation. To the best of our knowledge, this is the first case report describing a pediatric liver transplantation (PLT) using a graft with GA. CASE REPORT A 10-year-old boy with methylmalonic aciduria underwent isolated liver transplant with a deceased graft from a donor with no relevant medical or surgical history and normal laboratory tests. During the back-table liver preparation procedure, no evidence of gallbladder was found, raising the possibility of a GA, confirmed by intraoperative cholangiography. The liver transplantation procedure was uneventful despite the particularly rare combination of biliary tree anatomic distribution found in the cholangiography. At 1 year of follow-up, there were no clinical, laboratory, or imagological signs of bile leaks or anastomotic site stricture. DISCUSSION The present report highlights the importance of the accurate knowledge of the vasculobiliary anatomic variation, particularly in extremely rare cases, such as GA, and in complex hepatobiliary procedures, such as PLT. In our opinion, grafts with GA should not be discarded for transplantation.
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Affiliation(s)
- Inês Pessanha
- Department of Paediatric Surgery, Paediatric Hospital, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Henrique Alexandrino
- Department of General Surgery, Centro Hospitalar e Universitário de Coimbra, University Hospitals of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Cláudia Piedade
- Department of Paediatric Surgery, Paediatric Hospital, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Paediatric and Adult Liver Transplantation Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Catarina Cunha
- Department of Paediatric Surgery, Paediatric Hospital, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Paediatric and Adult Liver Transplantation Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Isabel Gonçalves
- Paediatric and Adult Liver Transplantation Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Maria Francelina Lopes
- Department of Paediatric Surgery, Paediatric Hospital, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Paediatric and Adult Liver Transplantation Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Emanuel Furtado
- Paediatric and Adult Liver Transplantation Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Pipia I, Kenchadze G, Demetrashvili Z, Nemsadze G, Jamburia L, Zamtaradze T, Abiatari I. Gallbladder agenesis: A case report and review of the literature. Int J Surg Case Rep 2018; 53:235-237. [PMID: 30428439 PMCID: PMC6232615 DOI: 10.1016/j.ijscr.2018.10.061] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/02/2018] [Accepted: 10/09/2018] [Indexed: 02/08/2023] Open
Abstract
Gallbladder agenesis presented with symptoms similar to biliary colic can be diagnosed without the need for surgical intervention. MRCP is considered a test of choice for diagnosis of gallbladder agenesis. If gallbladder agenesis is discovered during laparoscopy no conversion to laparotomy is needed.
Introduction Gallbladder agenesis is a rare congenital abnormality with an incidence of 10–65 per 100,000. Approximately half of these patients are surgically operated on because of the symptoms similar to biliary colic, and correct diagnosis is established intra-operatively. We present a clinical case of gallbladder agenesis from our practice. Presentation of case A 49 (forty-nine) - year- old women was admitted in the Emergency Department of our clinic. Symptoms were similar to the biliary colic. Ultrasonography showed hyperechogenic acoustic shadow on the projection of the gallbladder which was considered as constricted gallbladder and cholecystolithiasis was diagnosed. Laparoscopic cholecystectomy was considered. During laparoscopy gallbladder could not be found. Surgical operation was completed without conversion. Postoperative treatment included analgesics and antispasmodics. Pre-operative symptoms disappeared. One month later magnetic resonance cholangiopancreatography (MRCP) confirmed gallbladder agenesis diagnosis. Health condition of the patient is satisfactory, without any complications after a year of surgery. Discussion Gallbladder agenesis presented with symptoms similar to biliary colic can be diagnosed without surgical intervention. Conservative treatment consists of antispasmodic drugs. Conclusion If the shrunken gallbladder is detected on the ultrasound, additional radiological examinations are required. MRCP is considered as a test of choice among the radiological investigations. If gallbladder agenesis is identified on laparoscopy, there is no need for further conversion. For postoperative follow up examination MRCP investigation is recommended.
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Affiliation(s)
- Irakli Pipia
- Institute of Medical Research, Ilia State University, 3/5, Cholokashvili Ave., 0162, Tbilisi, Georgia; Department of Surgery, Kipshidze Central University Hospital, 29, Vazha-Pshavela Ave., 0160, Tbilisi, Georgia.
| | - George Kenchadze
- Institute of Medical Research, Ilia State University, 3/5, Cholokashvili Ave., 0162, Tbilisi, Georgia; Department of Surgery, Kipshidze Central University Hospital, 29, Vazha-Pshavela Ave., 0160, Tbilisi, Georgia.
| | - Zaza Demetrashvili
- Department of Surgery, Kipshidze Central University Hospital, 29, Vazha-Pshavela Ave., 0160, Tbilisi, Georgia; Department of Surgery, Tbilisi State Medical University, 33, Vazha-Pshavela Ave., 0177, Tbilisi, Georgia.
| | - Grigol Nemsadze
- Department of Radiology, Tbilisi State Medical University, 33, Vazha-Pshavela Ave., 0177, Tbilisi, Georgia; Department of Radiology, Kipshidze Central University Hospital, 29, Vazha-Pshavela Ave., 0160, Tbilisi, Georgia.
| | - Lika Jamburia
- Department of Radiology, Kipshidze Central University Hospital, 29, Vazha-Pshavela Ave., 0160, Tbilisi, Georgia.
| | - Tamari Zamtaradze
- Department of Surgery, Tbilisi State Medical University, 33, Vazha-Pshavela Ave., 0177, Tbilisi, Georgia.
| | - Ivane Abiatari
- Institute of Medical Research, Ilia State University, 3/5, Cholokashvili Ave., 0162, Tbilisi, Georgia.
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Moon AM, Howe JH, McGinty KA, Gerber DA. Gallbladder agenesis mimicking cholelithiasis in an adult. Radiol Case Rep 2018; 13:640-643. [PMID: 30167026 PMCID: PMC6114116 DOI: 10.1016/j.radcr.2018.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 03/08/2018] [Indexed: 11/17/2022] Open
Abstract
We present the case of a 24-year-old woman with morbid obesity who came to the emergency department with right upper quadrant abdominal pain associated with nausea and vomiting. Her workup included a right upper quadrant ultrasound suggestive of a small gallbladder with cholelithiasis without sonographic evidence of acute cholecystitis. She underwent attempted laparoscopic cholecystectomy with no identifiable gallbladder during surgery. Postsurgical cross-sectional imaging confirmed gallbladder agenesis. This case provides an example of a rare but convincing clinical and radiologic mimic of cholelithiasis. In certain cases of biliary colic and imaging revealing a small gallbladder, a magnetic resonance cholangiopancreatography may be warranted to evaluate gallbladder agenesis and avoid unnecessary surgery.
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Affiliation(s)
- Andrew M. Moon
- Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, 130 Mason Farm Rd, Bioinformatics Building CB# 7080, Chapel Hill, NC 27599-7080, USA
- Corresponding author.
| | - J. Hamilton Howe
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Katrina A. McGinty
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - David A. Gerber
- Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA
- Lineberger Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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V. Zlatić A, Ignjatović N, N. Djordjević M, Karanikolić A, M. Pešić I, Radovanović - Dinić B. AGENESIS OF THE GALL BLADDER: A CASE REPORT. ACTA MEDICA MEDIANAE 2018. [DOI: 10.5633/amm.2018.0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Kosmidis CS, Koimtzis GD, Kosmidou MS, Ieridou F, Koletsa T, Zarampouka KT, Georgakoudi E, Kesisoglou I. Gallbladder Hypoplasia, a Congenital Abnormality of the Gallbladder: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:1320-1324. [PMID: 29225328 PMCID: PMC5737095 DOI: 10.12659/ajcr.905963] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patient: Male, 62 Final Diagnosis: Gallbladder hypoplasia Symptoms: Abdominal pain Medication: — Clinical Procedure: — Specialty: Surgery
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Affiliation(s)
| | - Georgios D Koimtzis
- Third Department of Surgery, University Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Maria S Kosmidou
- Department of Internal Pathology, University Hospital of Ioannena, Ioannena, Greece
| | - Fotini Ieridou
- Third Department of Surgery, University Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Triantafyllia Koletsa
- Department of Pathology, Aristotle's University of Thessaloniki, Thessaloniki, Greece
| | - Katerina T Zarampouka
- Department of Pathology, Aristotle's University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Georgakoudi
- Third Department of Surgery, University Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Isaac Kesisoglou
- Third Department of Surgery, University Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
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