Agenesis of the gallbladder, a rare congenital anomaly that can mimic chronic cholecystitis: case report

Abstract

Agenesis of the gallbladder is a rare congenital malformation caused by the failure of the cystic bud to develop in the gallbladder, which may or may not be associated with other biliary malformations. It is an anomaly of variable symptomatology, with 50% of patients presenting symptoms mimicking biliary colic; it may be discovered by chance during surgery, while 15% may present fatal fetal malformations. When symptomatic, it is interpreted as chronic cholecystitis, with a narrowed appearance of the gallbladder on abdominal ultrasound, as the biliary structures may resemble those of a gallbladder, demonstrating the need for radiologists and surgeons to be aware of this diagnosis and its management, in order to avoid unnecessary surgery. In this article, we present a case of gallbladder agenesis in a young man who presented with hepatic colic-like symptoms suggestive of cholecystitis. The gallbladder was not well visualized on ultrasound, simulating chronic cholecystitis, and a Bili MRI concluded that the gallbladder was absent, thus avoiding surgery.