Vishwakarma Sunil, Singh Chhavindar, Agarwal Tripti, Sagar Aditya
General Surgery, Motilal Nehru Medical College, Prayagraj, IND.
Cureus. 2024 Jul 27;16(7):e65490. doi: 10.7759/cureus.65490. eCollection 2024 Jul.
Gallbladder agenesis is a rare anatomical variant, and most cases are asymptomatic and diagnosed on autopsy. Few of them may present with features suggestive of biliary tract pathology. A 32-year-old male presented with complaints of intermittent epigastric pain for three months. Abdominal ultrasonography was suggestive of chronic calculous cholecystitis, and he was planned for laparoscopic cholecystectomy. However, no gallbladder was found during the surgery. Postoperative evaluation was suggestive of an absent gallbladder with a normal ductal system. A provisional diagnosis of sphincter of Oddi dysfunction was made based on his symptoms. Congenital absence of gallbladder is a rare anomaly and only a few of the affected individuals are symptomatic. Lack of specific features, coupled with the inability of standard abdominal ultrasonography to detect the absence of gallbladder, can put the treating surgeon in a dilemma intraoperatively. Agenesis of the gallbladder is often missed and this entity should be kept in mind while having difficulty in visualizing the gallbladder. An astute surgeon should be wary of this diagnosis during difficult dissection to avoid bile duct injuries.
胆囊缺如是一种罕见的解剖变异，大多数病例无症状，在尸检时被诊断出来。其中少数可能表现出提示胆道病变的特征。一名32岁男性因间歇性上腹部疼痛三个月前来就诊。腹部超声提示慢性结石性胆囊炎，计划行腹腔镜胆囊切除术。然而，手术过程中未发现胆囊。术后评估提示胆囊缺如但胆管系统正常。根据其症状初步诊断为Oddi括约肌功能障碍。先天性胆囊缺如是一种罕见的异常情况，只有少数受影响的个体有症状。缺乏特异性特征，再加上标准腹部超声无法检测到胆囊缺如，可能会使主刀医生在术中陷入两难境地。胆囊缺如常常被漏诊，在难以看清胆囊时应牢记这一情况。在困难的解剖过程中，经验丰富的外科医生应警惕这一诊断，以避免胆管损伤。
