Agenesis of the gall bladder and cystic duct- interesting case report

Congenital absence of gall bladder is a very rare but well recognized congenital abnormality, the reported incidence ranging between 0.01 and 0.05. To our knowledge, this is a very rare case and all surgeons need to be aware of this unusual occurrence to prevent inadvertent injury to the dilated common hepatic duct. Laparoscopic cholecystectomy was planned on a suspected case of chronic cholecystitis and was found to have congenital absence of gall bladder and cystic duct. The diagnosis was confirmed by MRCP postoperatively . Standard investigations for chronic cholecystitis were misleading.Agenesis of gall bladder should be highly suspected whenever the gall bladder is not visualized on ultrasonography or at laparoscopy done on misinterpreted ultrasound. If the gall bladder is not seen at laparoscopy, further procedure should be avoided and agenesis should be confirmed by a combination of imaging modalities namely CT scan, MRCP , laparoscopic or endoscopic ultrasound, and HIDA scan if available. If the gall bladder is not visualized at preoperative ultrasound, a combination of imaging modalities should be used for diagnosis without recourse to laparoscopylaprotomy.