Molina Gabriel A, Ayala Andres V, Arcia Alberto C, Jiménez Galo E, Proaño Estefany J, Cadena C Augusto, Jimenez Andres, Raza Paula M
Attending Surgeon at Hospital Iess Quito Sur and Universidad San Francisco de Quito (USFQ), Ecuador.
Attending surgeon at Hospital Iess Quito Sur and UIDE, Ecuador.
Ann Med Surg (Lond). 2022 Apr 4;77:103585. doi: 10.1016/j.amsu.2022.103585. eCollection 2022 May.
Gallbladder agenesis is an extremely rare congenital condition in which most patients will remain asymptomatic; nonetheless, a small subset of patients will mimic biliary, urinary, or gastrointestinal disorders. As a result, if these patients are unaware of their condition, an ultrasound may be needed when they present with right upper abdominal pain, which can be misleading or inconclusive, putting the surgeon and the medical team in a diagnostic and intraoperative dilemma.
We present the case of a 36-year-old woman with a history of ventricular septal defect and cleft palate. She presented with abdominal pain to the emergency department. After an ultrasound, cholecystitis was misdiagnosed, and, unfortunately, the medical team did not realize this mistake. As a result, surgery was decided. After additional tests, gallbladder agenesis was diagnosed, and the patient fully recovered.
Congenital absence of the gallbladder can often pose a dilemma to surgeons when it is diagnosed during surgery. Preoperative diagnosis is highly challenging as it can mimic other pathologies; therefore, the medical team needs to keep this pathology on their list of differential diagnoses to avoid dangerous procedures.
Congenital absence of the gallbladder can often pose a dilemma to surgeons when it is diagnosed during laparoscopic cholecystectomy. Since preoperative diagnosis is challenging, communication between radiologists and surgeons is critical in order to provide proper care for any patient.
胆囊缺如是一种极其罕见的先天性疾病，大多数患者无症状；然而，一小部分患者会表现出类似胆道、泌尿系统或胃肠道疾病的症状。因此，如果这些患者不知道自己的病情，当他们出现右上腹疼痛时可能需要进行超声检查，而这可能会产生误导或诊断不明确，使外科医生和医疗团队陷入诊断和手术困境。
我们报告一例36岁女性患者，有室间隔缺损和腭裂病史。她因腹痛到急诊科就诊。超声检查后，被误诊为胆囊炎，不幸的是，医疗团队没有意识到这个错误。因此，决定进行手术。经过进一步检查，诊断为胆囊缺如，患者完全康复。
先天性胆囊缺如在手术中被诊断时，常常给外科医生带来困境。术前诊断极具挑战性，因为它可能与其他病症相似；因此，医疗团队需要将这种病症列入鉴别诊断清单，以避免危险的手术操作。
先天性胆囊缺如在腹腔镜胆囊切除术过程中被诊断时，常常给外科医生带来困境。由于术前诊断具有挑战性，放射科医生和外科医生之间的沟通对于为任何患者提供适当的治疗至关重要。
