Symptomatic Gallbladder Duplication With Mucocele and Calculi: An Anatomic Variant Diagnosed by CT

Gallbladder duplicates are generally asymptomatic and discovered incidentally; meanwhile, complications with gallbladder duplication, such as cholelithiasis and mucocele, can result in acute symptoms in the abdominal region with both complicated diagnostic and/or surgical difficulties. This report describes a 51-year-old male patient who presented to our facility with colicky right upper quadrant abdominal pain. Contrast-enhanced CT demonstrated true gallbladder duplication with two separate cystic ducts, one of which was distended secondary to a mucocele from an obstructing calculus. An elective cholecystectomy was performed, with intraoperative inspection revealing that there were two distinct anatomically separate gallbladders, and the two gallbladders demonstrated chronic cholecystitis with multiple calculi noted in both. The patient returned home on postoperative day five without complications. This case demonstrates perhaps the clinically relevant need to offer gallbladder duplication diagnosis, especially in an obstructive pathology context. To make the diagnosis and plan for the surgical procedure, preoperative imaging is required to direct an informed and ultimately safe approach to surgery that includes all intraoperative challenges of this duplicate anatomy and the best treatment to cure the patient.