Background: Aberrant gallbladder beneath the left liver is a rare congenital anomaly that is found in 0.1-0.7 per cent of the population and causes confusion on imaging and at operation.Two such cases are presented.
Case outlines: A man of 83 yr was explored for obstructive jaundice due to a hilar tumour, but the gallbladder was 'missing'. Exploration of a cystic mass to the left of the falciform ligament revealed a gallbladder attached to segment III of the liver. Laparotomy for gallstones in a woman of 70 yr failed to reveal the gallbladder until further dissection was carried out to the left of the falciform ligament. In each of these cases the cystic duct described a hairpin bend before joining the common hepatic duct on its right-hand side.
Conclusion: A left-sided gallbladder can be truly ectopic or may just appear so because the falciform ligament is aberrantly placed to the right. In either case preoperative imaging can be misleading, and a careful search is needed at operation. The incidence of disease seems no commoner than in orthotopic gallbladders.