Kowalchuk Roman O, Kowalchuk Roman M, Kaplan-List Katia, Oates Theodore K, Smith Sean C
University of Virginia School of Medicine, 1215 Lee St, Charlottesville, VA 22903, USA.
Department of Diagnostic Imaging, Rochester General Hospital, 1425 Portland Avenue, Rochester, NY 14621, USA.
Radiol Case Rep. 2018 Jul 5;13(4):904-908. doi: 10.1016/j.radcr.2018.06.002. eCollection 2018 Aug.
Gallbladder duplication is a rare anatomic variant of biliary anatomy, which can present diagnostic and treatment challenges. In this case, a 49-year-old male presented with classic symptoms of biliary colic to his primary care physician, and while computed tomography (CT) noted the presence of gallstones, neither CT nor ultrasound was able to locate a gallbladder within the gallbladder fossa. Initial surgery found and cauterized a rudimentary gallbladder, but symptoms persisted, requiring a second surgery and secondary analysis of CT, ultrasound, and magnetic resonance imaging with magnetic resonance cholangiopancreatography. Imaging helped clarify the diagnosis of gallbladder duplication (ductular type), where the first gallbladder's cystic duct inserted high on the common hepatic duct, and the second retroplaced gallbladder's cystic duct inserted into the midportion of the common bile duct. Thorough understanding of the numerous gallbladder duplication variants, careful interpretation of modern imaging, and close collaboration between surgeon and radiologist are essential for optimal management of patients with gallbladder duplications.
胆囊重复是一种罕见的胆道解剖变异，可能带来诊断和治疗方面的挑战。在本病例中，一名49岁男性因典型的胆绞痛症状就诊于其初级保健医生，虽然计算机断层扫描（CT）发现存在胆结石，但CT和超声均未能在胆囊窝内找到胆囊。初次手术发现并烧灼了一个发育不全的胆囊，但症状持续存在，需要进行第二次手术，并对CT、超声以及磁共振成像和磁共振胰胆管造影进行二次分析。影像学检查有助于明确胆囊重复（导管型）的诊断，其中第一个胆囊的胆囊管高位插入肝总管，而第二个后置胆囊的胆囊管插入胆总管中部。全面了解众多胆囊重复变异、仔细解读现代影像学检查结果以及外科医生与放射科医生之间的密切合作对于胆囊重复患者的最佳管理至关重要。
