Gallbladder duplication

Case contributed by Ana Paula Bavaresco
Diagnosis certain

Presentation

Recurrent episodes of abdominal pain in the right hypochondrium, worsening after meals.

Patient Data

Age: 35 years
Gender: Female
ultrasound
  • two elongated saccular structures of anechoic content at the gallbladder fossa, without flow on the Doppler study, reflecting duplicated gallbladder
  • one gallbladder showing slight parietal thickening
  • small echogenic structures inside one of the gallbladder, which were mobile in decubitus changes (gallstones)
  • normal common bile duct with diameter averages 6 mm

MRCP

mri

Two separate gallbladders with their own cystic ducts. 

Presence of gallstones inside the upper gallbladder and in the respective cystic duct.

Case Discussion

Gallbladder duplication is a rare congenital malformation with an incidence of 1 in 4000 autopsies. There is a classification for duplication of the gallbladder:  bi-lobed or double gallbladder. The first has a septum or invaginating cleft that separates the lumen into two chambers, and the second has two separate gallbladders with their own cystic ducts. Gallbladder diverticula, gallbladder fold, Phrygian cap, choledochal cyst, are some of the differential diagnoses for this pathology. The symptoms of gallbladder duplication are no different from that of the single gallbladder. The indication for surgery is still controversial, however, if it is necessary to remove one gallbladder, the removal of the other is suggested.

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