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Missing the main actor: Intra-operative diagnosis of agenesis of the gallbladder - When late is not 'too' late
Giuseppe Portale, Antonio Mazzeo, Chiara Cipollari, Roberto Isoardi, Y Spolverato, Matteo Zuin, Valentino Fiscon
Department of General Surgery, Azienda Euganea ULSS 6, Cittadella, Italy
Correspondence Address:
Giuseppe Portale,
Department of General Surgery, Azienda Euganea ULSS 6, Via Casa di Ricovero, 40, 35013 Cittadella, Padova
Italy
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/jmas.jmas_345_21 PMID: 35915520
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Agenesis of the gallbladder (AGB) without extrahepatic biliary atresia is a rare congenital disease. Ultrasound (US) examination can be misleading and reveal a contracted shrunken gallbladder when there is not any and the patient in most cases is taken to the OR for a standard cholecystectomy. We describe the case of a 54-year-old female with colicky right upper abdominal pain with nausea. US revealed a contracted scleroatrophic gallbladder and the patient was listed for laparoscopic cholecystectomy. At laparoscopy, despite careful search, the gallbladder was never visualised, and the suspicion of AGB was raised. An intra-operative cholangiography confirmed the hypothesis. The post-operative recovery was uneventful, and abdominal computed tomography scan failed to show the presence of gallbladder, therefore confirming the diagnosis of AGB. Lack of awareness of this condition among radiologists and surgeons is the main reason for unnecessary operations and potentially damages to the biliary tract.
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