Agenesis of the Gallbladder: A Phantom Menace
Bibliographic record
Abstract
Objective: Gallbladder agenesis (GBA) is a rare congenital disorder with an estimated incidence of about 0.06%. Despite the absence of a gallbladder, these patients may present with symptoms mimicking biliary colic or cholecystitis. Ultrasound findings and liver function tests are often misleading. Some of these patients undergo laparoscopy without successful identification of gallbladder and paradoxically report symptom relief. Case: We present a case of GBA in a 54 year-old female, who presented with right-sided abdominal pain. The clinical history and examination were consistent with biliary colic. Initial investigations, including liver function tests, upper endoscopy and ultrasound did not demonstrate upper gastrointestinal pathology and did not clearly identify a gallbladder. Subsequent HIDA scan and CT of the abdomen did not visualize a gallbladder. An MRCP confirmed gallbladder agenesis. The patient was managed conservatively and was symptom free on discharge and follow-up. Discussion: We wish to highlight four learning points: 1. Patients with gallbladder agenesis often present with biliary symptoms. 2. Ultrasound and CT of the liver may not always identify this anomaly. 3. MRCP is the gold standard for making a diagnosis of gall- bladder agenesis. 4. Surgeons must have a high index of suspicion of GBA when the gallbladder is poorly visualized or not identified on ultrasound.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.002 | 0.006 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.010 | 0.006 |
| Insufficient payload (model declined to judge) | 0.007 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".