Septate gallbladder
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At the time the article was created Hidayatullah Hamidi had no recorded disclosures.
View Hidayatullah Hamidi's current disclosuresAt the time the article was last revised Henry Knipe had the following disclosures:
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These were assessed during peer review and were determined to not be relevant to the changes that were made.
View Henry Knipe's current disclosures- Multiseptated gallbladder
- Honeycomb gallbladder
- Multiseptate gallbladder
Septate gallbladder is a congenital variant where there may be a single septum or multiple septa in the gallbladder splitting its lumen into several parts.
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Terminology
When there are multiple septa subdividing the gallbladder the condition is also known as multiseptate or honeycomb gallbladder. This is considered to be a separate condition to a single septate gallbladder by some 4.
Septate gallbladder is an independent entity from the junctional fold, where the gallbladder wall folds on itself. Junctional folds are usually thick and incomplete while septa are thin and may be complete.
Epidemiology
Multiseptate gallbladder is rare with only 150 cases in the global literature up to 2021. The condition has presented at all ages from neonate to elderly, most commonly in young adults 4.
Clinical presentation
When there is a single septum the condition is generally asymptomatic and incidentally detected on imaging.
When the gallbladder is multiseptate, which is rarer, the condition is symptomatic in about 75% cases, the commonest being right upper quadrant abdominal pain; other symptoms include nausea, vomiting and jaundice 4.
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Pathology
Etiology
In most cases septated gallbladder seems to be congenital due to abnormal embryogenesis of the developing gallbladder ref. However rare acquired cases have been seen due to trauma and inflammation 4.
Macroscopic appearance
There may be communication between the septated parts of gallbladder through small pores ref.
Markers
Liver function tests (LFTs) are normal in the majority of cases 4. A minority of cases show increased alkaline phosphatase, transaminases, bilirubin and/or gamma glutamyl transferase. Inflammatory markers are usually normal.
Radiographic features
Septated gallbladders are usually diagnosed with ultrasound 4.
History and etymology
The first article about multiseptated gallbladder was in German by A Knetsch in 1952 4,5. In 1963 the South African-American radiologist Morris Simon (1926-2005) 6 published a much fuller description which included detailed findings on oral cholecystography which was the gold standard method to evaluate the gallbladder at the time 3,4. Morris Simon was a chest radiologist at Beth Israel Hospital in Boston
References
- 1. Karaca, Turgut, Yoldas, Omer, Bilgin, Bulent Caglar, Bilgin, Selma, Evcik, Ender, Ozen, Saadet. Diagnosis and Treatment of Multiseptate Gallbladder with Recurrent Abdominal Pain. (2011) Case Reports in Medicine. doi:https://doi.org/10.1155/2011/162853
- 2. Al-Salem A, Issa H, Naserullah Z. Septate Gallbladder: A Report of Two Cases. Ann Saudi Med. 2002;22(5-6):351-3. doi:10.5144/0256-4947.2002.351 - Pubmed
- 3. Simon M & Tandon B. Multiseptate Gallbladder. Radiology. 1963;80(1):84-6. doi:10.1148/80.1.84 - Pubmed
- 4. Terkawi R, Qutob D, Hendaus M. Understanding Multiseptated Gallbladder: A Systematic Analysis with a Case Report. JGH Open. 2021;5(9):988-96. doi:10.1002/jgh3.12621 - Pubmed
- 5. Knetsch A. [Subdivided Gallbladders]. Fortschr Geb Rontgenstr. 1952;77(5):587-9. - Pubmed
- 6. Linton O. Morris Simon. Journal of the American College of Radiology. 2011;8(6):451. doi:10.1016/j.jacr.2011.02.006 - Pubmed
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