Gallbladder duplication

Case contributed by Dr Ian Crosbie

Presentation

RUQ pain, Murphy's positive

Patient Data

Age: 39
Gender: Male
Ultrasound

The liver parenchyma is homogeneous in echotexture, and its surface has a smooth contour. The contour of the parenchyma abutting the hepatic veins is reasonably smooth. Multiple echogenic liver lesions likely represent haemangioma.

Doppler scanning demonstrated normal direction of flow in the main portal vein. No porto systemic varices detected.

Two gallbladders are present. Both appear to have thick walls however are collapsed limiting assessment. No gallstones identified. The common bile duct measures 2 mm in maximal calibre.

No intrahepatic or extrahepatic duct dilatation was detected. Sonographic Murphey's positive.

The head and neck of the pancreas appear normal. The tail is poorly imaged due to overlying gas.

Conclusion

Duplicated gallbladder. Sonographic Murphey's positive. While the gallbladders appear thick walled, assessment is limited as they are largely collapsed. Splenomegaly.

CT

Duplex gallbladder. Each of the gallbladder lumens have a draining cystic duct which converge with the common hepatic duct in a single anastomosis to form the common bile duct. Single filling defect measuring 3 mm noted within the most medial gallbladder lumen.

Impression:

Duplex gallbladder and cystic ducts. The cystic ducts and the common hepatic duct have a single anastomosis forming the common bile duct.

Case Discussion

There are no specific symptoms attributed to gallbladder duplication and clinical symptoms are similar to that of a single gallbladder. Identification of duplication is important for operative planning prior to cholcystectomy. 

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Case information

rID: 39244
Case created: 27th Aug 2015
Last edited: 17th Oct 2017
Inclusion in quiz mode: Included

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