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Gallbladder Duplication with Dual Cholecystitis
Rhodes, E, D.O., Parikh, S, D.O; Beniwal,JS, M.D.
St. Joseph’s Regional Medical Center, Department of Surgery, Paterson, NJ
Introduction: Gallbladder duplication, or dual gallbladder, is an uncommon
entity encountered by surgeons. The approximate incidence of dual
gallbladders is 1/4000; however, most are never seen due to their
asymptomatic nature. When problems arise, such as cholecystitis, these
anomalies are uncovered. Here we present the case of a female with
gallbladder duplication along with dual cholecystitis, an exotic condition rarely
seen in literature.
Case: A 26 y/o female with 1 day of RUQ pain, intermittent in nature,
associated with nausea/vomiting presented to the emergency department.
After further work up, an ultrasound was done which was consistent with
cholecystitis. Following this, an MRCP showed no distal obstruction. Next a
HIDA scan was done in lieu of a dilated common bile duct on ultrasound,
along with elevated liver function tests. The HIDA showed delayed gallbladder
filling consistent with chronic cholecystitis. In the operating room, 2
gallbladders were seen on examination. Each had a separate cystic duct and
arterial supply and did not share a common wall. Both showed evidence of
cholecystitis and were therefore removed. On final pathology one gallbladder
showed evidence of acute inflammation while the other was identified as
having chronic inflammation.
Discussion: This case represents a rarity in the medical field. The patient
had imaging not consistent with the actual disease. Imaging modalities can
lead a surgeon astray if not taken within clinical context. With careful planning,
a surgeon can be prepared for much of the aberrant anatomy encountered
with typical preoperative symptoms.