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Agenesis of the gallbladder describes the rare congenital absence of the gallbladder.
overall incidence is estimated <0.1% (range 0.04-0.1%)
reported 3:1 female predominance of symptomatic cases
equivalent gender distribution in autopsy cases
Gallbladder agenesis is associated with several other anomalies:
Most patients with agenesis of the gallbladder are asymptomatic. Although some patients may present with signs and symptoms of gallbladder disease and ultrasound may suggest findings consistent with chronic cholecystitis (shrunken gallbladder). Jaundice may be present with a dilated common bile duct. There is a high incidence of choledocholithiasis.
Clearly it is important to establish that the patient has not had their gallbladder removed surgically.
The exact etiology is unknown, however it is thought to result either from failure of the cystic bud to form or from lack of vacuolation. Several cases of familial gallbladder agenesis have also been reported, suggesting a hereditary basis of the anomaly.
Treatment and prognosis
No treatment is needed if asymptomatic. However, patients symptomatic of biliary disease can be prescribed smooth muscle relaxants. Sphincterotomy can be performed if conservative treatment is ineffective 4.
Hystory and etymology
The first descriptions of cases of gallbladder agenesis occurred in 1701 and 1702 by Lemery and Bergman 4.
missed gallbladder on imaging/surgery
- 1. Meilstrup, Jon W.. Imaging Atlas of the Normal Gallbladder and Its Variants. (1994) ISBN: 0849347882
- 2. Ernest E. Lack. Pathology of the Pancreas, Gallbladder, Extrahepatic Biliary Tract, and Ampullary Region. (2003) ISBN: 9780199771745
- 3. Malde S. Gallbladder Agenesis Diagnosed Intra-Operatively: A Case Report. J Med Case Reports. 2010;4(1):1-5. doi:10.1186/1752-1947-4-285
- 4. Tagliaferri E, Bergmann H, Hammans S, Azizi A, Stüber E, Seidlmayer C. Agenesis of the Gallbladder: Role of Clinical Suspicion and Magnetic Resonance to Avoid Unnecessary Surgery. Case Rep Gastroenterol. 2017;10(3):819-25. doi:10.1159/000453656 - Pubmed