Left-sided gallbladder (LSG) associated with true diverticulum, a case report.

Abstract

The left-sided gallbladder (LSG) is a rare type of anatomical variation (ectopia) defined by the location of the bladder to the left side of the liver falciform and round ligaments. Initially reported in 1886 by Hochstetter, the finding is usually accidental since it is mostly an asymptomatic condition, thus not causing the patient any harm and being few reported cases in the current literature. Surgical cases are most associated with gallstones such as presented in this case report. Our patient was a 60-year-old man from Manaus who presented with symptomatic acute cholelithiasis submitted to laparoscopic cholecystectomy which allowed the visualization of true LSG concomitant with a polyp suggestive lesion. A diagnosis post-cholecystectomy of true gallbladder diverticulum was confirmed by histopathological analysis. Being one of three types of LSG, true LSG is more associated with other structural changes in the biliary tree and also some liver changes, in our case we identified no such alterations. True gallbladder diverticulum has, as the main characteristic, the herniation of all tissues of the gallbladder wall. When presented with LSG, is important to correctly identify the altered structures and adjust the surgical technique in the best way possible, it is up to the surgeon to adapt to the situation presented and ensure the best treatment for his patient.