Phrygian cap
Last revised by Rohit Sharma on 30 Sep 2024
Citation, DOI, disclosures and article data
Citation:
Gaillard F, Sharma R, Hacking C, et al. Phrygian cap. Reference article, Radiopaedia.org (Accessed on 05 Oct 2024) https://doi.org/10.53347/rID-1870
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rID:
1870
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Disclosures:
At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosures
Last revised:
30 Sep 2024,
Rohit Sharma ◉
Disclosures:
At the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.
View Rohit Sharma's current disclosures
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Systems:
Synonyms:
- Phrygian cap of gallbladder
Phrygian caps are the most common congenital anatomic variant of the gallbladder. It denotes folding of the fundus back upon the gallbladder body and is asymptomatic with no pathological significance.
On this page:
Radiographic features
A Phrygian cap may be identified on ultrasound, multiphase CT/MRI, or cholescintigraphy 3.
Ultrasound
May be wrongly interpreted as a septum in an otherwise normal gallbladder.
CT/MRI
Multiphase CT/MRI usually clearly differentiates Phrygian caps from mass lesions.
Nuclear medicine
Cholescintigraphy
When multiphase CT/MRI is inconclusive, cholescintigraphy may be critical in preventing an unnecessary cholecystectomy. The gallbladder often appears smaller than the gallbladder fossa. Delayed imaging demonstrates filling of the gallbladder, which rules out an underlying mass lesion.
Treatment and prognosis
As a benign anatomical variant, Phrygian caps should not be mistaken for a pathology and does not require treatment.
History and etymology
The appearance is reminiscent of a Phrygian cap, a head garment worn by inhabitants of Phrygia (modern Turkey) 1200-700 BCE 1,2. Of note, the Smurfs also wear a similar hat.
Differential diagnosis
adenomyomatosis (annular variant)
References
- 1. Meilstrup J, Hopper K, Thieme G. Imaging of Gallbladder Variants. AJR Am J Roentgenol. 1991;157(6):1205-8. doi:10.2214/ajr.157.6.1950867
- 2. Boyden EA. The phrygian cap in cholecystography: a congenital anomaly of the gallbladder. Am J Radiol 1935;33:589.
- 3. van Kamp M, Bouman D, Steenvoorde P, Klaase J. A Phrygian Cap. Case Rep Gastroenterol. 2013;7(2):347-51. doi:10.1159/000354789
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