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胆囊发育不全——一种具有常见症状的独特病症。

Gallbladder agenesis - a unique condition with common symptoms.

作者信息

Feyang Limbu Dison, Shrestha Ashish Kiran, Colledge Jann Yee

机构信息

General Surgery, William Harvey Hospital, Ashford TN24 0LZ, England.

Radiology, William Harvey Hospital, Ashford TN24 0LZ, England.

出版信息

J Surg Case Rep. 2025 Sep 20;2025(9):rjaf729. doi: 10.1093/jscr/rjaf729. eCollection 2025 Sep.

Abstract

Agenesis of the gallbladder is a rare abnormality with an incidence of 0.01%-0.06% and affects more women than men. Many patients can present with abdominal pain, particularly biliary colic. A woman presented with symptoms and signs of biliary colic-type pain. There was no history of cholecystectomy surgery. All her routine bloods, including inflammatory markers, liver function test, and amylase, were within normal limits. A combination of transabdominal ultrasound, computerised tomography (CT) scan, magnetic resonance cholangiopancreatography (MRCP), and hepatobiliary iminodiacetic acid (HIDA) scans concluded gallbladder agenesis without extrahepatic biliary atresia. Currently, she is being managed conservatively with analgesia and antispasmodics. Diagnosis begins by first excluding common pathologies. MRCP is the recommended investigation to diagnose gallbladder agenesis. Sphincter of Oddi dysfunction can cause biliary colic pain and this is suggested to be the mechanism of pain seen with gallbladder agenesis. Antispasmodic medication with simple analgesia is effective for management of symptoms.

摘要

胆囊缺如是一种罕见的异常情况,发病率为0.01% - 0.06%,女性患者多于男性。许多患者会出现腹痛,尤其是胆绞痛。一名女性表现出胆绞痛型疼痛的症状和体征。她没有胆囊切除术的病史。她所有的常规血液检查,包括炎症标志物、肝功能测试和淀粉酶,均在正常范围内。经腹超声、计算机断层扫描(CT)、磁共振胰胆管造影(MRCP)和肝胆闪烁造影(HIDA)扫描相结合,诊断为胆囊缺如且无肝外胆道闭锁。目前,她正在接受保守治疗,使用镇痛药和解痉药。诊断首先要排除常见病变。MRCP是诊断胆囊缺如的推荐检查方法。Oddi括约肌功能障碍可引起胆绞痛,这被认为是胆囊缺如时疼痛的机制。使用简单的镇痛药和解痉药对症状管理有效。

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本文引用的文献

1
Update on Sphincter of Oddi Dysfunction: A Review.Oddi括约肌功能障碍的最新进展:综述
J Clin Transl Hepatol. 2022 Jun 28;10(3):515-521. doi: 10.14218/JCTH.2021.00167. Epub 2022 Jan 11.
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Gallbladder agenesis: A case report and review of the literature.胆囊发育不全:一例病例报告及文献综述
Int J Surg Case Rep. 2018;53:235-237. doi: 10.1016/j.ijscr.2018.10.061. Epub 2018 Nov 1.
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The diagnosis of gallbladder agenesis: two cases report.胆囊缺如的诊断:两例报告
Int J Clin Exp Med. 2015 Feb 15;8(2):3010-6. eCollection 2015.
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Agenesis of the gallbladder: a case report.
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Gallbladder agenesis.胆囊缺如
Case Rep Gastroenterol. 2011 Sep;5(3):654-62. doi: 10.1159/000334988. Epub 2011 Dec 2.
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Agenesis of the gallbladder: difficulties in management.胆囊缺如:管理上的困难。
J Gastroenterol Hepatol. 2005 May;20(5):671-5. doi: 10.1111/j.1440-1746.2005.03740.x.

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