Adenomyomatosis of gallbladder
Patient attended for a health check up. She complained of vague, intermittent, dull ache in right upper quadrant.
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Gallbladder wall thickening with echogenic foci giving a comet tail appearance. Multiple small gallstones are visualized. No pericholecystic fluid present. Murphy’s sign is negative.
Adenomyomatosis of gall bladder is a rare entity and often an incidental finding and has no intrinsic malignant potential. It requires no specific treatment and is often seen with gallstones. Thickening of gall bladder wall occurs with hyperplasia of the muscularis mucosa and propria. Cholesterol crystals are also deposited in the wall giving it strawberry gall bladder appearance. Galbladder wall thickening with stones and sludge are characteristic of adenomyomatosis.
Ultrasound is often the primary modality. Galbladder wall thickening with stones and sludge are characteristic of adenomyomatosis. Echogenic intra mural foci giving V shaped or comet tail artifacts is also characteristic feature.
It can be difficult to differentiate it from cholesterosis of gall bladder. However gall bladder wall thickening is not present.