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Intramural gallstones mimicking typical lithiasic cholecystitis
Stylianos Apostolidis1, Apostolos Zatagias, Alexandros Zevgaridis
1Surgical Department, Euromedica Kyanous Stavros General Hospital, Thessaloniki, Greece.
Southern Medical Journal
|November 17, 2010
Summary
Intramural gallstones, a rare condition, can cause cholecystitis symptoms. This case highlights their association with gallbladder adenomyomatosis and challenges in ultrasound detection.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
Background:
- Gallstone disease is prevalent, particularly in Western populations.
- Intramural gallstones are exceptionally rare, with limited documented cases.
- Adenomyomatosis of the gallbladder is a benign condition characterized by hyperplasia of the gallbladder wall.
Observation:
- A 30-year-old female presented with symptoms consistent with cholecystitis.
- Laparoscopic cholecystectomy was performed.
- Intraoperatively, dark greenish intramural gallstones were discovered within the gallbladder wall.
Findings:
- Pathologic examination confirmed adenomyomatosis of the gallbladder.
- This represents the first reported case of intramural gallstones associated with cholecystitis.
- Ultrasound may not reliably detect intramural gallstones.
Implications:
- The findings expand the clinical spectrum of gallstone disease presentations.
- Early diagnosis and management strategies for intramural gallstones may need refinement.
- Despite rarity, intramural gallstones should be considered in the differential diagnosis of cholecystitis.
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