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Case Reports
. 2020 Sep 16;12(9):e10485.
doi: 10.7759/cureus.10485.

Gallbladder Adenomyomatosis Presenting With Abdominal Pain

Shravan Teelucksingh  1 , Tonya Welch  1 , Adrian Chan  1 , Jason Diljohn  1 , Fidel S Rampersad  1
Affiliations
Case Reports

Gallbladder Adenomyomatosis Presenting With Abdominal Pain

Shravan Teelucksingh et al. Cureus. .

Abstract

A previously well 50-year-old male presented with a six-year history of worsening right-sided upper abdominal pain, postprandial nausea, and early satiety. His blood tests, including full blood count, liver biochemistry, and serum amylase, were normal. CT of the abdomen with intravenous contrast demonstrated concentric segmental mural thickening of the body and fundus of the gallbladder, with intramural cystic foci (rosary sign). MRI of the abdomen demonstrated segmental gallbladder mural thickening with fluid-filled intramural diverticula (pearl necklace sign) and an hourglass configuration of the gallbladder, consistent with segmental gallbladder adenomyomatosis. The patient subsequently underwent laparoscopic cholecystectomy with histological confirmation of gallbladder adenomyomatosis, without evidence of malignancy. His postoperative recovery was uneventful.

Keywords: ct; gallbladder adenomyomatosis; mri.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Axial contrast-enhanced CT image shows concentric thickening and enhancement of the gallbladder wall at the body and fundus with small mural cystic foci (arrow) representing the “rosary sign”.
Figure 2
Figure 2. Axial T2-weighted MRI image shows mural thickening, fluid-filled intramural diverticula (arrow) representing the “pearl necklace sign”.
Figure 3
Figure 3. Coronal T2-weighted MRI image showing mural thickening of the gallbladder fundus and body with fluid-filled intramural diverticula (red arrow) and an hourglass configuration (black arrow) consistent with gallbladder adenomyomatosis (segmental type).
Figure 4
Figure 4. Image of a longitudinal gross section of the gallbladder shows thickening of the gallbladder wall at the body and fundus and multiple cystic intramural cavities (arrows) corresponding to Rokitansky-Aschoff sinuses.
Figure 5
Figure 5. Micrograph with H and E stain showing (black arrow) herniation of mucosa into muscular wall (Rokitansky-Aschoff sinus) and other cystic glandular formations with a thickened gallbladder wall, consistent with gallbladder adenomyomatosis.
See this image and copyright information in PMC

References

    1. Hyperplastic cholecystoses; Hickey lecture, 1960. Jutras JA. http://pubmed.ncbi.nlm.nih.gov/14408274/ Am J Roentgenol Radium Ther Nucl Med. 1960;83:795–827. - PubMed
    1. Focal thickening at the fundus of the gallbladder: computed tomography differentiation of fundal type adenomyomatosis and localized chronic cholecystitis. Kim BS, Oh JY, Nam KJ, et al. Gut Liver. 2014;8:219–223. - PMC - PubMed
    1. Diffuse gallbladder wall thickening: differential diagnosis. van Breda Vriesman AC, Engelbrecht MR, Smithuis RH, Puylaert JB. AJR Am J Roentgenol. 2007;188:495–501. - PubMed
    1. Clinics in diagnostic imaging (121). Gallbladder adenomyomatosis. Poonam Y, Ashu S, Rohini G. http://smj.sma.org.sg/4903/4903me2.pdf. Singapore Med J. 2008;49:262–264. - PubMed
    1. The pathogenesis and radiographic progress of gallbladder adenomyomatosis. (Article in Chinese) Xu YB, Zhang PJ, Xue F. Chin J Clinicians. 2015;9:2187–2190.

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