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January 22, 1982

The Gallbladder in Polycystic Liver Disease

JAMA. 1982;247(4):462. doi:10.1001/jama.1982.03320290012013

To the Editor.—  In a BRIEF REPORT entitled "The Gallbladder in Polycystic Liver Disease" (1981;246:864), Woodring et al aptly describe how polycystic liver disease can mimic intrinsic disease of the gallbladder. An even more unusual circumstance can occur when polycystic liver disease secondarily induces truly surgical problems in the gallbladder.

Report of a Case.—  A 59-year-old man, who eight years earlier underwent bilateral nephrectomy for end-stage renal failure secondary to polycystic kidney disease, had a ten-day history of symptoms compatible with biliary colic. Because findings from the usual diagnostic tests (an oral cholecystogram and ultrasound) were inconclusive, the patient underwent endoscopic retrograde cholangiopancreatography, which showed complete cystic duct obstruction owing to a rounded lesion 1 cm from the junction of the cystic and common hepatic ducts. This was assumed to be a gallstone impacted in the cystic duct, but operative findings showed the lesion to be an intraluminal cyst that