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2020, Number 2

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Acta Med 2020; 18 (2)

Choledocholithiasis as the first manifestation of vesicular agenesis

González MJJ, Cázares RTK, Nájera RIA, Aguilar SÓA, Landero YVT

Language: Spanish
References: 10
Page: 191-193
PDF size: 181.54 Kb.


ABSTRACT

Congenital absence of gallbladder is unusual, with an incidence of 0.02%. Gallbladder agenesis detection is mostly incidental, and when symptomatic, it is associated to choledocholithiasis in 50% of the cases. A 68-year-old male, with a history of 8 months of intermittent jaundice and abdominal pain, reports fever for a week. Generalized jaundice, abdominal pain at right upper quadrant without Murphy’s sign, and elevated serum direct bilirubin were evident. The ultrasound and the MRC showed bile duct dilatation, with a gallstone at de common bile duct, but no gallbladder. After unsuccessful ERCP, surgery with choledochotomy was decided to extract one 1.2 cm stone, and a T-tube cholangiogram showed the absence of cystic duct and gallbladder. Gallbladder agenesis, when associated with choledocholithiasis, can be a diagnostic and therapeutic challenge.


REFERENCES

  1. Tjaden J, Patel K, Aadam A. Gallbladder agenesis with refractory choledocholithiasis. Case Rep Gastrointest Med. 2015; 2015: 747931.

  2. Trompetas V, Panagopoulos E, Ramantanis G. Gall-bladder agenesis presenting with obstructive jaundice and elevated CA 19-9. Acta Chir Bbelg. 2004; 104: 347-349.

  3. Tang LM, Wang XF, Ren PT, Xu GG, Wang CS. The diagnosis of gallbladder agenesis: two cases report. Int J Clin Exp Med. 2015; 8 (2): 3010-3016.

  4. Fiaschetti V, Calabrese G, Viarani S, Bazzochi G, Simonetti G. Gallbladder agenesis and cystic duct absence in an adult patient diagnosed by magnetic resonance cholangiography. Case Rep Med. 2009; 2009: 674768.

  5. Sasaki K. Congenital agenesis of the gallbladder with the hypogenetic cystic duct definitely diagnosed by peroral cholangioscopy. Gastroenterol Pancreatol Liver Disord. 2014; 1 (3): 1-4.

  6. Quintana AB, Díaz FJ, Lamikiz AV, Valdevieso AL, Perdigo L. Ausencia-desaparición de la vesícula biliar en un paciente diagnosticado de colelitiasis. Cir Esp. 2005; 78 (5): 331-332.

  7. Waisberg J, Pinto PE, Gusson PR, Fasano PR, de Godoy AC. Agenesis of the gallbladder and cystic duct. Sao Paulo Med J. 2002; 120 (6): 192-194.

  8. Toshihide O, Susumo T. Complication of endoscopic therapeutic lithotripsy for choledocholithiasis. JJBA. 2010; 24: 754-761.

  9. Maple JT, Ben-Menachem T, Anderson MA, Appalaneni V, Banerjee S, Cash BD et al. The role of endoscopy in the evaluation of suspected choledocholithiasis. Gastrointest Endosc. 2010; 71 (1): 1-9.

  10. Garteiz-Martínez D, Weber-Sánchez A, López-Acosta ME. Laparoscopic T-tube choledochotomy for biliary lithiasis. JSLS. 2008; 12: 326-331.




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