Prenatal and accurate perinatal diagnosis of type 2 H or ductular duplicate gallbladder

BMC Pediatr. 2018 Feb 7;18(1):38. doi: 10.1186/s12887-018-1043-9.

Abstract

Background: Double gallbladder is a rare biliary anomaly. Perinatal diagnosis of the disorder has been reported in only 6 cases, and in 5 of them the diagnosis was based on ultrasound imaging only. However, the ultrasound technique alone does not provide a sufficiently precise description of cystic ducts and biliary anatomy, an information that is crucial for a correct classification and for a possible future surgery.

Case presentation: At 21 weeks of gestational age of an uneventful pregnancy in a 38 year old primipara mother, a routine ultrasound screening detected a biliary anomaly in the fetus suggestive of a double gallbladder. A neonatal abdominal ultrasonography performed on postnatal day 2 confirmed the diagnosis. On day 12 the newborn underwent a Magnetic Resonance Cholangiopancreatography (MRCP) that clearly characterized the anatomy of the anomaly: both gallbladders had their own cystic duct and both had a separate insertion in the main biliary duct.

Conclusions: We report a case of early prenatal suspected duplicate gallbladder that was confirmed by a neonatal precise diagnosis of a Type 2, H or ductular duplicate gallbladder, using for the first time 3D images of Magnetic resonance cholangiopancreatography in a newborn. An accurate anatomical diagnosis is mandatory in patients undergoing a possible future cholecystectomy, to avoid surgical complications or reoperations. Therefore, in case of a perinatal suspicion of a double gallbladder, neonates should undergo a Magnetic resonance cholangiopancreatography. A review of the Literature about this variant is included.

Keywords: Boyden classification; Cholangiopancreatography; Fetal sonography; Gallbladder duplication; Gallbladder/abnormalities; Gallbladder/diagnostic imaging; H-type cystic duct duplication; Infant; MRCP; Magnetic resonance; Newborn; Pregnancy; Prenatal; Ultrasonography.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cholangiopancreatography, Magnetic Resonance*
  • Congenital Abnormalities / diagnostic imaging*
  • Female
  • Gallbladder / abnormalities*
  • Gallbladder / diagnostic imaging*
  • Humans
  • Imaging, Three-Dimensional
  • Infant, Newborn
  • Pregnancy
  • Ultrasonography, Prenatal*