Which gallbladder condition is described as a thickened muscular layer of the gallbladder wall, a type of hyperplastic cholecystitis?

Which gallbladder condition is described as a thickened muscular layer of the gallbladder wall, a type of hyperplastic cholecystitis?

• A. Rokitansky-Aschoff Sinuses
• B. Adenomyomatosis
• C. Biloma
• D. Pneumobilia

Answer: (B)

Adenomyomatosis. This is a benign, hyperplastic change of the gallbladder where the muscular layer of the wall thickens and the mucosa forms intramural diverticula called Rokitansky-Aschoff sinuses. The thickened muscular layer is the characteristic feature, and on ultrasound you may see wall thickening with small intramural cystic spaces that can produce comet-tail (reverberation) artifacts from the sinuses. Rokitansky-Aschoff sinuses are related—mucosal outpouchings within the thickened wall—but the defining finding described here is the thickened muscular layer. The other options describe different scenarios: a biloma is a bile leak collection outside the biliary system, and pneumobilia is air within the biliary tree.

Adenomyomatosis. This is a benign, hyperplastic change of the gallbladder where the muscular layer of the wall thickens and the mucosa forms intramural diverticula called Rokitansky-Aschoff sinuses. The thickened muscular layer is the characteristic feature, and on ultrasound you may see wall thickening with small intramural cystic spaces that can produce comet-tail (reverberation) artifacts from the sinuses. Rokitansky-Aschoff sinuses are related—mucosal outpouchings within the thickened wall—but the defining finding described here is the thickened muscular layer. The other options describe different scenarios: a biloma is a bile leak collection outside the biliary system, and pneumobilia is air within the biliary tree.