Agenesis of Gall Bladder

Abstract

Although biliary system variants are common, isolated congenital absence / agenesis of gall bladder (AGB) is
extremely rare. Despite an absent gallbladder, half of the patients present with symptoms similar to biliary colic.
The patients without gallbladder are usually operated because a 'false' interpretation of ultrasonography. When
ultrasonography reveals a 'sclero-atrophic' gallbladder or in cases of non-visualization in other imaging modalities,
the need to further preoperative investigation must be in the surgeon's mind. It seems that MRCP is the most
accurate non-invasive diagnostic tool to establish the diagnosis of AGB and to avoid unnecessary and risky
surgery when combined with the other non- invasive investigations. When confronted with this situation on table
the surgeon should abort the procedure, in absence of other pathology. Further dissection is not necessary and it
may risk injury to vital structure. Diagnosis may be confirmed later by MRCP. The treatment is conservative with
analgesics and anti spasmodics.