Gallbladder Agenesis: Must General Surgeons Have It on Their Diagnostic Algorithm?

Gallbladder agenesis is a rare congenital malformation that can present itself with comparable symptoms as any case of cholelithiasis. We present a case of a 76-year-old male patient without any medical background of significance who presented at the ER complaining of sudden abdominal pain that started two hours prior to his arrival. Laboratory tests were ordered and an increase in total bilirubin was noted, showing a cholestatic pattern. An abdominal ultrasound was performed where the gallbladder could not be found; therefore, an abdominal CT and an MRI were ordered, which later confirmed gallbladder agenesis. Endoscopic retrograde cholangiopancreatography (ERCP) was then performed with sphincterotomy and the patient was discharged 24 hours later without any complications noted. Gallbladder agenesis is a rare but important diagnosis that general surgeons must have in their diagnostic repertoire because of its ability to mimic acute cholecystitis or cholelithiasis. The objective of this report is to summarize the principal details of this entity.