Adenomyomatosis of the Gallbladder as a Cause of Recurrent Abdominal Pain

Adenomyomatosis of the Gallbladder as a Cause of Abdominal Pain in Pediatrics: A Case Report of an Adolescent and a Literature Review

Objectives

Adenomyomatosis (ADM) of the gallbladder is a benign condition, which is characterized by mucosal hyperplasia of the gallbladder and formation of intramucosal invagination through the thickened mucosal layer. The pathogenesis is unclear. This condition is rare in children. The aim of this publication is to present the case of a teenager with ADM of the gallbladder and review the pediatric literature on this topic.

Methods

A 17-year-old female presented with severe postprandial right upper quadrant abdominal pains. The abdominal ultrasound revealed ADM of the gallbladder.

Results

A curative laparoscopic cholecystectomy was performed. Since 1998, eleven of the 13 pediatrics cases reported with ADM of the gallbladder were symptomatic and a cholecystectomy was curative in all of them.

Conclusion

ADM of the gallbladder should be considered in the differential diagnosis of recurrent right abdominal upper quadrant pains in pediatrics. Abdominal ultrasound is the best diagnostic procedure. In symptomatic patients, a cholecystectomy is curative.

Gallbladder polyps and adenomyomatosis

Incidental findings are commonly detected during examination of the gallbladder. Differentiating benign from malignant lesions is critical because of the poor prognosis associated with gallbladder malignancy. Therefore, it is important that radiologists and sonographers are aware of common incidental gallbladder findings, which undoubtedly will continue to increase with growing medical imaging use. Ultrasound is the primary imaging modality used to examine the gallbladder and biliary tree, but contrast-enhanced ultrasound and MRI are increasingly used. This review article focuses on two common incidental findings in the gallbladder; adenomyomatosis and gallbladder polyps. The imaging features of these conditions will be reviewed and compared between radiological modalities, and the pathology, epidemiology, natural history, and management will be discussed.

Combined Fundal and Segmental Adenomyomatosis of the Gallbladder in a Child: A Rare Case Report

Adenomyomatosis of the gallbladder (AMG) is characterized by mucosal hyperplasia leading to invagination through the thickened muscle layer, which is relatively common in adults, but is rare in childhood. We report a 12-year-old boy with adenomyomatosis of the gallbladder combined segmental and fundal type. This combined type is rare in adults and is first reported here in childhood. Although initial imaging with computed tomography (CT) suggested the presence of a circular solid mass-like lesion because of its rare morphology, repeated ultrasonography (US) was useful for leading to a correct diagnosis.