Structural abnormalities in close proximity with the gallbladder fossa such as gallbladder duplications could be misrepresented as choledochal cysts, duodenal duplication cysts or gallbladder adenomyomas on sonography. We present a case of a ten year old boy who presented with a chronic abdominal pain of a three month duration and nausea and vomiting. Ultrasound and magnetic resonance cholangiopancreaticoography (MRCP) was reported by radiology as a possible 2.7 x 1.7 x 1.6 cm choledochal cyst

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... ith high differential consideration for a gallbladder duplication. The patient underwent a diagnostic laparoscopy and a grossly normal gallbladder was visualized with no gross visualization of cystic biliary tree dilatation. The gallbladder was successfully resected laparoscopically following a meticulous dissection of the triangle of calot. Pathology showed evidence of a septate gallbladder with a common cystic duct and no evidence of cholelithiasis. The patient is two years post -laparoscopic cholecystectomy and remains symptom-free. Successful laparoscopic resection of a duplicate gallbladder requires a pre-operative diagnostic delineation of the biliary tree anatomy to rule out other possible differentials.