Agenesis of the Gallbladder with Primary Choledochal Stones

OBJECTIVE: To report a case of true agenesis of the gallbladder (GB) with obstructive jaundice due to primary choledochal stone. CLINICAL PRESENTATION AND INTERVENTION: A 66-year-old woman presented with a full picture of obstructive jaundice, both clinically and biochemically. Ultrasound and endoscopic retrograde cholangiopancreatography failed to show the GB but showed dilatation of extrahepatic ducts with a stone in the common bile duct (CBD). Upon exploration, the GB was found to be absent and through a choledochotomy, the stone in the CBD was removed. CONCLUSION: This case shows that proper exploratory laparotomy and intraoperative cholangiography may be required to confirm absence of the GB.