Left Hepatic Lobe Agenesis With Ectopic Gallbladder.

Raana Kanwal,Samina Akhtar

doi:10.7759/cureus.16131

Abstract

An ectopically located gallbladder is a rare entity. Here, we present a case of an ectopic gallbladder with left hepatic lobe agenesis. In this study, we describe the case of a 56-year-old male who was a known diabetic patient. He presented with abdominal pain, which started two weeks prior. Computed tomography (CT) abdomen with contrast was advised by the primary team, which showed an incidental ectopic gallbladder along the right posterior-inferior margins of the liver. Associated with it, there was complete agenesis of the left hepatic lobe, including absent segments II, III, and IV. Most of the commonly encountered ectopic positions include intrahepatic, transverse, retrohepatic, retroperitoneal, suprahepatic, falciform ligament, or under the left liver lobe. Ectopic gallbladders have clinical significance as they alter the clinical presentation of cholecystitis. They create technical challenges during cholecystectomy and other biliary operations and cause misdiagnosis in imaging. A thorough inspection of the biliary tract in patients undergoing surgery is suggested before electrocoagulation. A radiologist must always inform the clinician about the existence of an aberrant gallbladder.

Highlights

Reported congenital liver anomalies include hypoplasia or agenesis of hepatic lobes, absent segment, and agenesis of gallbladder [1]
Imaging modality has a crucial role in determining the anatomy, including vascular anomalies, biliary duct details, and variations
Contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) are modalities of choice, with MRI being of higher yield without radiation exposure and contrast administration [3]

Summary

Introduction

Reported congenital liver anomalies include hypoplasia or agenesis of hepatic lobes, absent segment, and agenesis of gallbladder [1]. Agenesis of the hepatic lobe is an incidental finding as the patient remains asymptomatic [2]. To the best of our knowledge and literature review, associated ectopic gallbladder with left hepatic lobe agenesis is rarely reported. We present a case of an ectopic gallbladder with left hepatic lobe agenesis. Contrast-enhanced CT abdomen and pelvis was acquired as a single-phase acquisition at approximately 60-90 seconds after intravenous contrast administration, which showed complete agenesis of the left hepatic lobe, including segments II, III, and IV (Figure 1). The ectopic gallbladder was found incidentally along the right posterior-inferior margins of the liver (Figure 4). The patient was called and inquired about the medical treatment provided to him, to which he showed a satisfactory response

Discussion

Conclusions

Disclosures

Prithishkumar IJ