Phrygian Cap Gallbladder and Recurrent Pancreatitis in a Woman

Abstract

A 65-year-old woman with hypothyroidism and arterial hypertension was admitted with epigastric pain and hyperemesis. Five months before, she had the diagnosis of non-lithiasic acute pancreatitis without complications, and the hypothesized etiology was alcohol abuse. The current manifestations were initially related to an active gastric ulcer evidenced by the endoscopic study. Laboratory data were consistent with acute pancreatitis, and ultrasonography showed images of pancreatitis, in addition to the incidental detection of the hydropic gallbladder with a Phrygian cap. These diagnoses were confirmed by the imaging study of computed tomography with contrast. Clinical significance of Phrygian cap anomaly is herein emphasized because of diagnostic challenges, in addition to possible etiopathogenic role in cholecystitis, gallstones, and pancreatitis. The eventual association of the gallbladder anomaly with the Saint’s triad is also commented. This scarcely reported triad includes hiatus hernia, diverticulosis, and lithiasic cholecystopathy.