Mena Ana K, Quiroz Humberto, Sánchez Cynthia, Oliva Alejandro H, Ávila Daniela
General Surgery, Hospital General Regional No. 1, Instituto Mexicano del Seguro Social (IMSS), Querétaro, MEX.
Cureus. 2025 Aug 11;17(8):e89777. doi: 10.7759/cureus.89777. eCollection 2025 Aug.
Gallbladder agenesis is a rare congenital anomaly that is often asymptomatic but may present with clinical features mimicking biliary tract disease. The absence of the gallbladder is frequently undetected by abdominal ultrasound, leading to diagnostic uncertainty and potential surgical dilemmas. Accurate preoperative diagnosis is essential to avoid unnecessary surgical exploration and iatrogenic complications. We report a case of a 67-year-old male who presented with acute cholangitis secondary to choledocholithiasis. Cross-sectional imaging (CT and magnetic resonance cholangiopancreatography) revealed no identifiable gallbladder, while endoscopic retrograde cholangiopancreatography was inconclusive due to the presence of a large common bile duct stone. Laparoscopic exploration of the biliary tract was performed, resulting in the extraction of a 20 mm stone and intraoperative confirmation of gallbladder agenesis. This case emphasizes the importance of considering gallbladder agenesis in the differential diagnosis of biliary symptoms and highlights the need for comprehensive imaging to guide appropriate management and avoid unnecessary surgical risk.
胆囊缺如是一种罕见的先天性异常，通常无症状，但可能表现出类似胆道疾病的临床特征。腹部超声常常无法检测到胆囊缺失，导致诊断不确定以及潜在的手术困境。准确的术前诊断对于避免不必要的手术探查和医源性并发症至关重要。我们报告一例67岁男性患者，因胆总管结石继发急性胆管炎就诊。横断面成像（CT和磁共振胰胆管造影）未发现可识别的胆囊，而由于存在较大的胆总管结石，内镜逆行胰胆管造影结果不明确。遂进行了腹腔镜胆道探查，取出了一枚20毫米的结石，并在术中证实了胆囊缺如。该病例强调了在胆道症状鉴别诊断中考虑胆囊缺如的重要性，并突出了需要综合成像来指导恰当的治疗管理并避免不必要的手术风险。
