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Case report
peer-reviewed

Clinical Cholecystitis in the Absence of the Gallbladder



Abstract

The congenital absence of the gallbladder (CAG) is a rare condition with an incidence of 13-65 cases/ 100,000 in the general population. This occurs when the gallbladder and the cystic duct fail to bud from the common bile duct during the fifth week of gestation. Most commonly, the patients with congenital absence of the gallbladder are asymptomatic. When symptomatic, they present as biliary colic, dyspepsia, jaundice or very rarely as acute cholecystitis. We present a case of a 27-year-old female who presented with acute right upper quadrant abdominal pain. Further evaluation with an ultrasound revealed a contracted gallbladder with stones. The hepatobiliary iminodiacetic acid scan was significant for non-visualization of the gallbladder, consistent with cystic duct obstruction. The laparoscopic cholecystectomy was attempted, however, the gallbladder was not visualized, and the procedure was aborted. The post-operative magnetic resonant cholangiopancreatography was consistent with the diagnosis of congenital absence of gallbladder.



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Case report
peer-reviewed

Clinical Cholecystitis in the Absence of the Gallbladder


Author Information

Huda Naim

Internal Medicine, Dow Medical College, Karachi, Pakistan

Syed Askari Hasan Corresponding Author

Internal Medicine Residency, Florida Hospital

Sameen Khalid

Internal Medicine Residency, Florida Hospital-Orlando

Aamer Abbass

Internal Medicine Residency, Florida Hospital-Orlando

Jason DSouza

Internal Medicine Residency, Florida Hospital-Orlando


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.


Case report
peer-reviewed

Clinical Cholecystitis in the Absence of the Gallbladder


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Case report
peer-reviewed

Clinical Cholecystitis in the Absence of the Gallbladder

Huda Naim">Huda Naim, Syed Askari Hasan">Syed Askari Hasan , Sameen Khalid">Sameen Khalid, Aamer Abbass">Aamer Abbass, Jason DSouza">Jason DSouza

  • Author Information
    Huda Naim

    Internal Medicine, Dow Medical College, Karachi, Pakistan

    Syed Askari Hasan Corresponding Author

    Internal Medicine Residency, Florida Hospital

    Sameen Khalid

    Internal Medicine Residency, Florida Hospital-Orlando

    Aamer Abbass

    Internal Medicine Residency, Florida Hospital-Orlando

    Jason DSouza

    Internal Medicine Residency, Florida Hospital-Orlando


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements


    Article Information

    Published: November 10, 2017

    DOI

    10.7759/cureus.1834

    Cite this article as:

    Naim H, Hasan S, Khalid S, et al. (November 10, 2017) Clinical Cholecystitis in the Absence of the Gallbladder. Cureus 9(11): e1834. doi:10.7759/cureus.1834

    Publication history

    Received by Cureus: August 03, 2017
    Peer review began: September 14, 2017
    Peer review concluded: November 02, 2017
    Published: November 10, 2017

    Copyright

    © Copyright 2017
    Naim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The congenital absence of the gallbladder (CAG) is a rare condition with an incidence of 13-65 cases/ 100,000 in the general population. This occurs when the gallbladder and the cystic duct fail to bud from the common bile duct during the fifth week of gestation. Most commonly, the patients with congenital absence of the gallbladder are asymptomatic. When symptomatic, they present as biliary colic, dyspepsia, jaundice or very rarely as acute cholecystitis. We present a case of a 27-year-old female who presented with acute right upper quadrant abdominal pain. Further evaluation with an ultrasound revealed a contracted gallbladder with stones. The hepatobiliary iminodiacetic acid scan was significant for non-visualization of the gallbladder, consistent with cystic duct obstruction. The laparoscopic cholecystectomy was attempted, however, the gallbladder was not visualized, and the procedure was aborted. The post-operative magnetic resonant cholangiopancreatography was consistent with the diagnosis of congenital absence of gallbladder.



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Huda Naim

Internal Medicine, Dow Medical College, Karachi, Pakistan

Syed Askari Hasan, M.D.

Internal Medicine Residency, Florida Hospital

For correspondence:
syedaskarih@gmail.com

Sameen Khalid, M.D.

Internal Medicine Residency, Florida Hospital-Orlando

Aamer Abbass

Internal Medicine Residency, Florida Hospital-Orlando

Jason DSouza

Internal Medicine Residency, Florida Hospital-Orlando

Huda Naim

Internal Medicine, Dow Medical College, Karachi, Pakistan

Syed Askari Hasan, M.D.

Internal Medicine Residency, Florida Hospital

For correspondence:
syedaskarih@gmail.com

Sameen Khalid, M.D.

Internal Medicine Residency, Florida Hospital-Orlando

Aamer Abbass

Internal Medicine Residency, Florida Hospital-Orlando

Jason DSouza

Internal Medicine Residency, Florida Hospital-Orlando