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Case Reports in Gastrointestinal Medicine
Volume 2015, Article ID 747931, 3 pages
http://dx.doi.org/10.1155/2015/747931
Case Report

Gallbladder Agenesis with Refractory Choledocholithiasis

Rush University Medical Center, Chicago, IL 60612, USA

Received 3 March 2015; Revised 12 June 2015; Accepted 16 June 2015

Academic Editor: Ruud J. L. F. Loffeld

Copyright © 2015 Jamie Tjaden et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Congenital agenesis of the gallbladder is a rare anomaly which is usually asymptomatic and found incidentally. In some cases, however, patients are symptomatic. Common symptoms include right upper quadrant abdominal pain, nausea, and vomiting. Jaundice is present in some symptomatic cases and is due to associated choledocholithiasis (Fiaschetti et al. 2009). In this case, a 63-year-old female presents with jaundice and episodic right upper quadrant abdominal pain with nausea and vomiting. Bilirubin and alkaline phosphatase were found to be markedly elevated. Upper endoscopic ultrasound (EUS) revealed choledocholithiasis, and the patient required multiple endoscopic retrograde cholangiopancreatography (ERCP) sessions before successful extraction of all stones. Subsequent surgical exploration revealed congenital agenesis of the gallbladder. Although this is a rare finding, patients with agenesis of the gallbladder are at increased risk of developing de novo choledocholithiasis which may be challenging to extract.