tailieunhanh - Gallbladder agenesis with hepatic impairment: A case report

Gallbladder agenesis is a rare congenital malformation. More than 50% of cases are isolated and asymptomatic. These asymptomatic patients are principally healthy and need no interventions. However, some patients develop symptoms, presenting with clinical signs and complaints similar to those of biliary tract disease. Symptoms commonly occur in the fourth or fifth decade of life of the patient. | Takano et al. BMC Pediatrics 2018 18 360 https s12887-018-1343-0 CASE REPORT Open Access Gallbladder agenesis with hepatic impairment a case report Yoshihiko Takano Mirei Hoshino Sakae Iriyama Kyoko Takayanagi Manabu Ishiro Nobuhiro Kawakami and Takayuki Okamura Abstract Background Gallbladder agenesis is a rare congenital malformation. More than 50 of cases are isolated and asymptomatic. These asymptomatic patients are principally healthy and need no interventions. However some patients develop symptoms presenting with clinical signs and complaints similar to those of biliary tract disease. Symptoms commonly occur in the fourth or fifth decade of life of the patient. At the present time gallbladder agenesis is diagnosed using a combination of imaging modalities without surgical intervention to avert serious complications following surgery. Case presentation We describe a 13-year-old Japanese girl with a history of recurrent hepatic impairment which had not been thoroughly investigated. She was referred to our hospital following 2 days of fever fatigue and abnormal blood tests suggested impaired liver function. Data from chest X-ray findings combined with a positive loop-mediated isothermal amplification assay result indicated Mycoplasma pneumoniae pneumonia which was treated with oral azithromycin. To investigate potential hepatic impairment we performed several imaging studies namely abdominal ultrasonography magnetic resonance cholangiopancreatography and contrast enhanced computed tomography. These imaging studies revealed a normal liver however the gallbladder was not in the usual nor any aberrant position in imaging investigations of the patient. Based on these results we diagnosed gallbladder agenesis however the etiology of her hepatic impairment has not been elucidated. Conclusion We present a case of gallbladder agenesis with hepatic impairment where the diagnosis was made without surgical intervention. Clinicians should perform a detailed

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