Laparoscopic cholecystectomy is one of the commonest operations performed worldwide. Chronic cholecystitis can present with a small contracted gall bladder and in the setting of typical biliary type symptoms is an indication for surgery. Rarely, congenital agenesis of the gall bladder on imaging can mimic a small contracted gall bladder. Not uncommonly surgery is performed with the intent of removing the gall bladder only to find agenesis of the organ. Common bile duct injury is a real concern in these situations given the lack of familiar gall bladder anatomy. Extreme caution has to be advised to prevent injury to the ducts.
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