February 2010

Abnormal gallbladder

Clinical Info

Vague pain in the upper abdomen. The laboratory findings are normal.

Ultrasound Images & Clips

Male 71 years old, Vague pain in the upper abdomen. The laboratory findings are normal.

Longitudinal image of the gallbladder with an abnormally thickened wall especially in the central part of the gallbladder. The cranial part of the gallbladder is relatively normal. There are multiple small diverticula in the thickened part of the gallblad
Longitudinal image of the gallbladder with an abnormally thickened wall especially in the central part of the gallbladder. The cranial part of the gallbladder is relatively normal. There are multiple small diverticula in the thickened part of the gallblad
Longitudinal image of the gallbladder fundus also showing a thickened wall with small divericula. In some of them there are hyperechoic foci.
Longitudinal image of the gallbladder fundus also showing a thickened wall with small divericula. In some of them there are hyperechoic foci.
Transverse image of the gallbladder fundus showing a thickened wall with small diverticula and hyperechoic foci.
Transverse image of the gallbladder fundus showing a thickened wall with small diverticula and hyperechoic foci.
Videoclip
videoclip

Conclusion

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.


Details

  • Sex: Male
  • Age: 71

Created with

  • Hitachi Ultrasound System