15 Adenomyomatosis of Gallbladder

Clinical Presentation

A 45-year-old Caucasian woman presents with recurrent right upper quadrant pain made worse after having fatty food.

Fig. 15.1 Axial contrast-enhanced CT image shows an annular area of narrowing in the gallbladder with dumbbell-shaped compartmentalization. There are associated outpouchings in the gallbladder wall and thickening.

Radiologic Findings

An axial contrast-enhanced computed tomography (CT) image shows an annular area of narrowing in the gallbladder with dumbbell-shaped compartmentalization. There are associated outpouchings in the gallbladder wall and thickening (Fig. 15.1).

Diagnosis

Adenomyomatosis of gallbladder

Differential Diagnosis

Chronic cholecystitis
Gallbladder carcinoma

Discussion

Background

Adenomyomatosis is found in 3% of the cholecystectomy specimens and is associated with thickening of the gallbladder wall with the presence of intramural diverticuli, which may contain bile, biliary sludge, or cholesterol crystals. Adenomyomatosis may be associated with cholesterolosis in some cases.