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Gallbladder agenesis and pancreas divisum

Case contributed by Dr Ammar Haouimi

Presentation

Epigastric pain. No past history of surgery.

Patient Data

Age: 50 years
Gender: Female

The gallbladder and cystic duct are not visualized on any sequence including on 3D-MRCP. The common bile duct is dilated (10 mm in diameter) with no distal obstruction, may be assuming the function of bile storage.

Coronal MRCP reveals a dorsal pancreatic duct crossing anterior to the common bile duct, draining into the expected location of the minor papilla, indicating pancreas divisum. 

Case Discussion

MRI features suggestive of a gallbladder agenesis with associated pancreas divisum. This association has been reported in the literature 1.

Gallbladder agenesis is an extremely rare congenital malformation, with an incidence between 0.013 to 0.075% 2. The cystic duct can be absent, patent or shows hypoplastic cystic appearance 3. Several reported studies revealed a strong familial association. It can be seen in both adults and children.

MRCP (magnetic resonance cholangiopancreatography) is the gold standard imaging modality to exclude the possibility of an ectopic gallbladder and confirm the diagnosis. Preoperative MRCP should be performed in cases in which gallbladder is not visualized on ultrasound examination, before any surgical decision. 

 

Additional contributor: R. Bouguelaa MD

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Case information

rID: 64876
Published: 16th Dec 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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