Persistent Acalculous Biliary Colic - Gallbladder Flexion - A Case Report

Abstract

Among the main benign pathologies that cause anatomical and physiological dysfunction of the gallbladder is gallbladder kinking, also known as "Phrygian cap gallbladder." This is defined as an anatomical anomaly that causes a flexure of one of the gallbladder's portions, which can lead to a narrowing of the organ's lumen, compromising the proper emptying of its contents. This can result in the formation of gallstones, cholecystitis, and even vascular compromise. This pathology is usually asymptomatic, being an incidental finding during surgery or imaging studies. However, it can present with symptoms such as biliary colic, nausea, vomiting, and fever. This report describes the case of a 16-year-old female patient who presented repeatedly to the emergency department with episodes of abdominal pain without a documented etiology, and with normal imaging studies. The patient presented with a clinical picture suggestive of biliary colic. An abdominal ultrasound was performed, confirming the diagnosis by revealing gallbladder kinking without the presence of gallstones. The patient underwent surgery, where a conventional cholecystectomy was performed, successfully resolving the condition.