Virginia Research Day 2025

Medical Student Research Case Reports

05 Missing In Action: The Case of the Gallbladder That Never Was

Yash Desai; Prutha Patel; Chetan Pai, DO, MBA Corresponding author: ydesai@vcom.edu

Mary Washington Healthcare, Fredericksburg, VA

Gallbladder agenesis is a rare congenital anomaly with an incidence of 10 to 60 per 100,000 individuals. It is typically discovered incidentally during autopsy or through imaging when patients present with biliary symptoms. This case report discusses a 75-year-old male who presented with generalized abdominal pain and signs of cholangitis. Initial imaging revealed the absence of the gallbladder, and further evaluation with MRCP confirmed the diagnosis. The patient's clinical picture was complicated by pneumobilia, leading to additional imaging and endoscopic evaluation. Early recognition of gallbladder agenesis is essential

to avoid unnecessary surgical interventions, as its presentation can mimic other biliary diseases such as cholecystitis and choledocholithiasis. The report highlights the importance of thorough patient history and appropriate use of imaging in diagnosis. Management of gallbladder agenesis depends on the patient's symptoms and long-term follow-up is recommended to monitor for recurrent complications, though most patients experience favorable outcomes. The authors received patient consent to use their data for this report.

Figure: This figure depicts the MRCP that was taken of the biliary system. The gallbladder is not visualized, and there is a duodenal diverticulum (DD) separating the common bile duct (CBD) and pancreatic duct (PD).

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2025 Research Recognition Day