{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T05:01:53Z","timestamp":1764219713098,"version":"3.46.0"},"reference-count":17,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,11,6]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>With the growth of laparoscopy, open cholecystectomies are often reserved for exceedingly inflamed and difficult gallbladders. We present a case of a patient in her 70s with a history of malrotation and omphalocele requiring silo management with recurrent admissions for acute cholecystitis. She had failed a prior laparoscopic converted to open attempt at cholecystectomy. She presented with right upper quadrant abdominal pain and Computed Tomography (CT) showing numerous anomalies. She was taken to the operating room where her liver was mobilised and eviscerated out of the abdomen; gallbladder was truly intrahepatic. Portal structures and intrahepatic gallbladder were confirmed with intraoperative ultrasound. The gallbladder was subsequently removed with external Pringle and direct liver parenchymal dissection. This case demonstrates that a critical understanding of anatomy with thorough analysis of imaging is essential in patients with extensive adhesive disease or altered anatomy, particularly congenital defects.<\/jats:p>","DOI":"10.1136\/bcr-2025-267433","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T03:45:14Z","timestamp":1764215114000},"page":"e267433","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Open cholecystectomy via liver evisceration with a history of neonatal malrotation and omphalocele"],"prefix":"10.1136","volume":"18","author":[{"given":"Deepa","family":"Chandhrasekhar","sequence":"first","affiliation":[{"name":"General Surgery Residency, Virginia Mason Franciscan Health, Tacoma, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katelyn","family":"Anderson","sequence":"additional","affiliation":[{"name":"General Surgery Residency, Virginia Mason Franciscan Health, Tacoma, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie X","family":"Du","sequence":"additional","affiliation":[{"name":"General Surgery Residency, Virginia Mason Franciscan Health, Tacoma, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Sich","sequence":"additional","affiliation":[{"name":"General Surgery Residency, Virginia Mason Franciscan Health, Tacoma, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"2025112619450587000_18.11.e267433.1","first-page":"92","article-title":"Anatomy anomalies of the biliary tree","volume":"1","author":"Bockman","year":"1992","journal-title":"Laparososc Surg"},{"key":"2025112619450587000_18.11.e267433.2","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1159\/000462964","article-title":"Two Anomalies in One: A Rare Case of an Intrahepatic Gallbladder with a Cholecystogastric Fistula","volume":"11","author":"Ali","year":"2017","journal-title":"Case Rep Gastroenterol"},{"key":"2025112619450587000_18.11.e267433.3","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1936.01180190134008"},{"key":"2025112619450587000_18.11.e267433.4","doi-asserted-by":"crossref","first-page":"50","DOI":"10.4103\/1319-3767.58771","article-title":"Ectopic gall bladder: A rare case","volume":"16","author":"Popli","year":"2010","journal-title":"Saudi J Gastroenterol"},{"key":"2025112619450587000_18.11.e267433.5","first-page":"1029","article-title":"Liver scanning and the intrahepatic gallbladder: Case report","volume":"16","author":"Schulz","year":"1975","journal-title":"J Nucl Med"},{"key":"2025112619450587000_18.11.e267433.6","first-page":"396","article-title":"Intrahepatic gallbladder","volume":"121","author":"Mcnamee","year":"1974","journal-title":"Am J Roentgenol Radium Ther Nucl Med"},{"key":"2025112619450587000_18.11.e267433.7","doi-asserted-by":"crossref","unstructured":"Falk V , Low G , Bigam D , et al . Acute acalculous cholecystitis of an intrahepatic gallbladder causing Mirizzi\u2019s syndrome. 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