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Case Reports
. 2011 Oct 5:11:106.
doi: 10.1186/1471-230X-11-106.

Rare gallbladder adenomyomatosis presenting as atypical cholecystitis: case report

Sheng-Hong Lin  1 , Feng-Yee Chang, Ya-Sung Yang, Jong-Shiaw Jin, Teng-Wei Chen
Affiliations
Case Reports

Rare gallbladder adenomyomatosis presenting as atypical cholecystitis: case report

Sheng-Hong Lin et al. BMC Gastroenterol. .

Abstract

Background: Gallbladder adenomyomatosis is a benign condition characterized by hyperplastic change in the gallbladder wall and overgrowth of the mucosa because of an unknown cause. Patients with gallbladder adenomyomatosis usually present with abdominal pain. However, we herein describe a case of a patient with gallbladder adenomyomatosis who did not present with abdominal pain, but with only fever.

Case presentation: A 34-year-old man presented to our hospital with a fever. No abdominal discomfort was declared. His physical examination showed no abnormalities. Ultrasound of the abdomen revealed thickness of the gallbladder. Acute cholecystitis was diagnosed. The fever persisted even after 1 week of antibiotic therapy. Magnetic resonance imaging of the abdomen showed gallbladder adenomyomatosis with intramural Rokitansky-Aschoff sinuses. Exploratory laparotomy with cholecystectomy was performed. The fever recovered and no residual symptoms were reported at the 3-year follow-up.

Conclusions: Gallbladder adenomyomatosis can present with fever as the only symptom. Although the association between gallbladder adenomyomatosis and malignancy has yet to be elucidated, previous reports have shown a strong association between gallbladder carcinoma and a subtype of gallbladder adenomyomatosis. Surgical intervention remains the first-choice treatment for patients with gallbladder adenomyomatosis.

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Figures

Figure 1
Figure 1
Gallium-67 inflammation scan. A rim-like lesion with gradually increasing intensity over the right upper quadrant of the abdomen was noticed in the gallbladder fossa.
Figure 2
Figure 2
Magnetic resonance imaging of the abdomen. Marked thickening of the epithelial and muscular elements in the gallbladder with multiple variably sized intramural cysts (arrow) was observed in the T1- (A) and T2-weighted (B) sequences, which is consistent with adenomyomatosis of the gallbladder with intramural Rokitansky-Aschoff sinuses.
Figure 3
Figure 3
Surgery specimen showing a huge gallbladder with multiple intramuscular cysts and abscesses.
See this image and copyright information in PMC

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