Congenital absence of gall bladder in a young Saudi medical student. Clinical, laboratory findings and analysis of body composition.

ongenital absence of gallbladder (CAGB) is an extremely rare anomaly of the biliary system and is important in clinical practice as it may cause some clinical, surgical and diagnostic problems.1 Approximately 400 cases have so far been reported in the literature with a reported incidence ranging between 0.013-0.075%.2 Subjects with gall bladder agenesis are classified into 3 categories, symptomatic (55.5%); asymptomatic (31.6%) and multiple fetal anomalies (12.9%).2 The CAGB may cause feeling of stuffed and stuck after eating, irritating gas symptoms, dyspepsia, pain in epigastrium and upper right quadrant, diarrhea, biliary colic and jaundice.3,4 The present communication describes the first case of CAGB to be reported in the Kingdom of Saudi Arabia (KSA) with special emphasis on clinical, hematological findings and body composition. In this study, the subject was a 20-year-old Saudi student at the College of Pharmacy, King Saud University, Riyadh, KSA. One day after a discussion on the functions and applied physiology of gall bladder in the lecture hall, the student came forward and asked some questions regarding the functions of liver and gall bladder then gave a history of pain in right hypochondrium. Physical examination showed a pulse rate of 80 beats/min; respiratory rate 18 times/min; blood pressure 120/70mm Hg and temperature was 98.4oF. In addition, subject was also examined for anemia, cyanosis, jaundice, edema, clubbing, koilonychia and lymph node enlargement but no abnormal findings were observed. Ultrasonography of the abdomen with special emphasis to biliary system showed the absence of gall bladder. The ultrasonography of the abdomen was repeated in a different radiology division for second opinion and results were confirmed. Computerized tomography scan of the biliary system also failed to locate the gall bladder. Laboratory investigations revealed complete blood count (CBC) and showed no abnormal findings; RBCs 5.5x106/μL, hemoglobin 16.0 g/dl, HCT 47.3%, MCH 28.7 pg, MCHC 33.7 g/dl, WBCs 5.8x103/μL; neutrophils 64%, eosinophils 2%, basophils 0.3%, lymphocyte 27.8%, C Clinical Notes