[Adenomyomatosis vesicae felleae]

Abstract

Adenomyomatosis of the gall bladder is a condition of benign hyperplasia of unknown etiology. Characteristic of the condition is local or diffuse thickening of the muscular layer with invagination of the epithelium forming the so-called Rokitansky-Aschoff's sinus. The prevalence is unknown. In a prospective autopsy material, localized adenomyomatosis, adenomyoma, was found in 7%. This is considered to be the lowest value for the prevalence in the older age groups. Cholecystography and cholecystectomy materials show varying frequencies of adenomyomatosis, 2-33%. There is no definite proof that adenomyomatosis is a symptom-producing condition but several studies suggest that it may be and that in selected cases it may be treated by cholecystectomy. Selection depends upon the duration and severity of the symptoms. Routine diagnosis may be made with the aid of ultrasonic scanning. In more obscure cases with symptoms from the biliary tract, oral cholecystegraphy may be recommended possibly including exposures after a meal rich in fats or after administration of cholecystokinine.