Key clinical message:
Congenital liver anomalies are rarely reported. To the best of our
knowledge and literature review, associated gallbladder agenesis with
left hepatic lobe agenesis is extremely rare. The rarity of this
condition and its uncertain radiological features often leads to
misdiagnosis and unwarranted surgical treatments.
Keywords: liver; hypoplasia; segmental; gallbladder; agenesis;
MRCP
A 52 year-old South East Asian male presented to the surgical OPD with a
complain of non-specific colicky abdominal pain and heartburn. He didn’t
have any history of medical or surgical illness. No history of trauma,
infections or carcinoma was present. Family history is unremarkable. On
examination, vitals were stable. Systemic examination was normal.
Baseline laboratory investigations were found to be within normal
limits. Gallbladder was not visualized well on the ultrasound. Contrast
enhanced CT (CECT) abdomen and MRCP was done. CECT showed absence of III
and IVB segments of left lobe of liver (Figure 1). MRCP revealed absence
of gallbladder with intact common hepatic duct, common bile duct and
pancreatic duct appearing normal in caliber and course (Figure 2). An
incidental finding of left segmental hypoplasia of liver with
concomitant gallbladder agenesis was made. Furthermore, upper
gastrointestinal endoscopy was performed. Diagnosis of gastroesophageal
reflux disease (GERD) was established. He was managed conservatively and
on regular follow-up, he is free of symptoms. No any surgical
intervention was done.
Congenital liver anomalies are rarely reported. Some of these include
hypoplasia, deformed or agenesis of hepatic lobes, absent segment, and
agenesis of the gallbladder.1 Agenesis of the hepatic
lobe is an incidental finding as the patient remains
asymptomatic.2 Initially, acquired causes of lobar
absence like traumatic, vascular, infectious, carcinomatous, or
metabolic should be ruled out.3 However, to our
knowledge, only associated ectopic gallbladder with left hepatic lobe
agenesis is reported.4 To the best of our knowledge
and literature review, associated gallbladder agenesis with left hepatic
lobe agenesis is extremely rare. The rarity of this condition and its
uncertain radiological features often leads to misdiagnosis and
unwarranted surgical treatments.