Agenesis of gallbladder—an unexpected absence in laparoscopy

Gallbladder agenesis is a very rare condition, majority of which are normally diagnosed intraoperatively because of low index of suspicion and high rate of false positive results for cholecystitis on ultrasound imaging. We present a case of a 25-year-old man who presented with a right upper quadrant pain, whose ultrasound suggests a contracted gallbladder with gallstones. He was treated as an acute on chronic cholecystitis and booked for laparoscopic cholecystectomy. Intraoperatively, there was no gallbladder to be seen and decision was made to abandon procedure and avoid further exploration. Post-operative magnetic resonance cholangiopancreatography confirmed the congenital agenesis of gallbladder. It is important to have awareness of this condition, and possible further imaging modalities should be used if the ultrasound suggests a shrunken or contracted gallbladder that is not easily visible to avoid the risk of undergoing an unwarranted surgery.