Imaging in Double Gall Bladder with Acute Cholecystitis—A Rare Entity

Abstract

Duplication of gall bladder is a rare congenital anomaly of the hepatobiliary system. It is a very important entity in clinical practice as preoperative diagnosis plays a significant role in the management and to avoid unnecessary bile duct injury during surgery. We report a case of duplicated gall bladder presenting as acute cholecystitis.

A case report of duplex gallbladder and review of the literature

“…USS is the first-line investigation and is highly sensitive in assessing gallstones, cholecystitis and gallbladder anatomical abnormalities [4] . Gocmen et al [5] and Ozgen et al [6] reports limitations of USS in failing to differentiate between the various pathologies of the gallbladder as described in the differential diagnoses above, therefore warranting further investigation such as MRCP, CT, oral cholecystography, percutaneous transhepatic cholangiogram or HIDA scan [1,4,7,9,11] . MRCP is superior to USS for anatomical evaluation of the biliary tree.…”

“…In the absence of a definite diagnosis ERCP can help to demonstrate a DG with contrast-filling of the biliary tree. However, it is invasive and the operator may miss a second gallbladder demonstrated by the contrast [7,8] . Therefore MRCP is now the widely accepted choice of investigation for duplicate gallbladder pathology [7] .…”

Duplicate gallbladder: A case report of a patient with cholecystitis after cholecystectomy

“…Perioperative imaging options include abdominal CT scans, hepatobiliary iminodiacetic scanning, endoscopic retrograde cholangiopancreatography, transcutaneous cholangiography, or intraoperative cholangiograms, all of which delineate the biliary tree to varying precision [[8], [9], [10], [11], [12]]. However, magnetic resonance cholangiopancreatography (MRCP) and ERCP more precisely illustrate complicated anatomy even in disease states [[8], [9], [10], [11], [12]]. MRCP has the added advantage of not only imaging the biliary tree but also the viscera itself to aid in diagnosis.…”

A Conceptual Model Relationship between Industry 4.0—Food-Agriculture Nexus and Agroecosystem: A Literature Review and Knowledge Gaps

“…Figure 14 shows the conceptual relationships between the agroecosystem and three related UN-SDGs, where food items are deficient in quantity and quality in today's and future societies under the presence and impacts of environmental stresses (climate change) factors. Therefore, the connectivity between agriculture and I4 stems from the need for food sustainability and sustainable FSC [200][201][202][203][204][205][206][207][208][209][210][211][212][213][214][215][216][217]. Population increase, climate change, food waste, and pandemics have hampered global food security [39].…”