Malde Sachin
Department of Surgery, Fairfield General Hospital, Rochdale Old Road, Bury, BL9 7TD, UK.
J Med Case Rep. 2010 Aug 23;4:285. doi: 10.1186/1752-1947-4-285.
Agenesis of the gallbladder is a rare congenital anomaly occurring in 13 to 65 people of a population of 100,000. The rarity of the condition, combined with clinical and radiologic features that are indistinguishable from those of more common biliary conditions, means that it is rarely diagnosed preoperatively, and patients undergo unnecessary operative intervention.
This case report describes the case of a 79-year-old symptomatic Caucasian man who underwent laparoscopic cholecystectomy for suspected choledocholithiasis despite imaging studies raising suspicion of gallbladder agenesis. Intra-operatively, the diagnosis of gallbladder agenesis and associated common bile duct stones was made.
The preoperative diagnosis of this rare condition is difficult to make. However, with advances in biliary tract imaging and with heightened awareness of this anomaly, fewer patients will need to undergo unnecessary operative intervention. The authors review the different imaging modalities available to help diagnose this condition and highlight the importance of being aware of this rare anomaly to avoid an operation that carries a high risk of iatrogenic injury.
胆囊缺如是一种罕见的先天性异常,在每10万人中约有13至65人发病。这种病症的罕见性,再加上其临床和放射学特征与更常见的胆道疾病难以区分,意味着它很少在术前被诊断出来,患者会接受不必要的手术干预。
本病例报告描述了一名79岁有症状的白种男性患者,尽管影像学检查怀疑胆囊缺如,但因疑似胆总管结石接受了腹腔镜胆囊切除术。术中诊断为胆囊缺如及相关胆总管结石。
这种罕见病症的术前诊断很难做出。然而,随着胆道成像技术的进步以及对这种异常情况认识的提高,需要接受不必要手术干预的患者将会减少。作者回顾了有助于诊断这种病症的不同成像方式,并强调了认识这种罕见异常以避免进行具有高医源性损伤风险手术的重要性。