Vague pain in the upper abdomen. The laboratory findings are normal.
The diagnosis is an adenomyomatosis which is a benign hyperplastic cholecystosis. It is a relatively common condition .
Adenomyomatosis is most often an incidental finding. It has no malignant potential, and usually requires no treatment. The hyperechoic foci are precipitated cholesterol crystals in the bile trapped in the intramural diverticula called Rokitansky-Aschoff sinuses The small diverticula are best seen with a high frequency probe.
Gallbladder involvement by adenomyomatous hyperplasia is variable in extent and location, with heterogeneous imaging appearances corresponding to diffuse, segmental, and focal adenomyomatosis. This case represents a segmental form.
Sometimes adenmyomatosis can lead to abnormal gallbladder contractions which may result in vague abdominal complaints.
The differential diagnosis include a cholecystitis and a gallbladder carcinoma. In most cases however the diagnosis will not be a problem.
Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.
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