One of my patients, a 35-year-old woman, recently had some short-lived, fairly mild pain in the right upper quadrant. Physical examination and liver function tests were normal. An upper abdominal ultrasound was reported as showing adenomyomatosis of the gallbladder. Does the gall bladder need to be removed?
Adenomyomatosis of the gall bladder is a non-neoplastic condition in which there is hyperplasia of the mucous membrane and extension of the glandular structures into the muscularis of the gall bladder wall, associated with muscle hypertrophy. The protrusions of the mucosa are like small diverticula, and are known as Rokitansky–Aschoff sinuses. The condition probably arises on a basis of increased pressure in the gall bladder lumen, possibly due to a neurogenic dysfunction either in the neck of the gall bladder or in the common bile duct.