Overview
Aplasia of the gallbladder is a rare congenital anomaly characterized by the complete absence of the gallbladder, often associated with malformations of the liver, particularly the quadrate lobe, and can present with symptoms such as intermittent vomiting of bile and hepatopathy 12.Diagnosis
Clinical Presentation: Intermittent vomiting of bile, signs of hepatopathy 1.
Imaging: Abdominal ultrasound or CT scan revealing absence of gallbladder and associated liver malformations 1.
Surgical Exploration: Exploratory celiotomy confirms the absence of the gallbladder and identifies associated anatomical abnormalities 1.
Histopathology: Histological evidence may show bile duct proliferation and portal fibrosis 1.Management
Surgical Intervention: Exploratory celiotomy to confirm diagnosis and assess for concurrent anomalies 1.
Supportive Care: Management of symptoms such as bile acid supplementation if cholestasis is present, though specific dosing is not detailed 1.
Monitoring: Regular follow-up to monitor for complications like common duct stones 2.Special Populations
Pediatrics: Case reports suggest early surgical exploration is crucial for diagnosis and management 1.
Comorbidities: Presence of associated liver malformations may necessitate multidisciplinary care 1.Key Recommendations
Perform exploratory celiotomy for definitive diagnosis and assessment of associated liver malformations in suspected cases (Evidence: Weak 1).
Regular monitoring for complications such as common duct stones is essential in managing patients with gallbladder aplasia (Evidence: Weak 2).
Supportive care measures should be tailored to manage symptoms like cholestasis, though specific pharmacological interventions require further evidence (Evidence: Expert opinion 1).References
1 Liptak JM, Swinney GR, Rothwell TL, Hunt GB. Aplasia of the gallbladder in a dog. The Journal of small animal practice 2000. link
2 Wählby L. Aplasia of the gallbladder with common duct stones. Acta chirurgica Scandinavica 1977. link