Presentation
Presented with non-specific loin pain with no history of previous surgery. The ultrasound scan revealed a paraumbilical hernia but failed to visualize the gallbladder and was repeated with the same findings. Non enhanced CT scan of the upper abdomen was done to confirm the findings.
Patient Data

The gallbladder is absent. The common bile duct is not dilated. A small splenule is seen at the splenic hlium.
Case Discussion
In cases of non-visulaized gallbladder on ultrasound scan, most commonly the reason is either the patient is not fasting or has previously underwent cholecystectomy.
This patient presented for his first ultrasound scan (not shown) and denied any previous surgery. As the gallbladder was not visualized, a repeat ultrasound (also not shown) was performed. CT scan was subsequently done to confirm the findings. Other imaging techniques can be used for confirmation, e.g. MRI, MRCP or ERCP depending on availability.