Adenomyomatosis of the gall bladder: the NUH experience

Adenomyomatosis (AD) is a degenerative disorder of the gall bladder wall which can be complicated by chronic inflammation and calculi. The true incidence of this disorder in South East Asians is not known. Nine Chinese patients with AD were discovered amongst 200 consecutive right upper quadrant ultrasound examinations. Four of them had cholecystectomy and were diagnosed as cholecystitis by the pathologist. Adenomyomatosis can be suspected on ultrasonography, but should be confirmed by oral cholecystography (OCG). There is great disparity in the ultrasound, OCG, surgical and histopathological diagnosis of this condition. This may be due to the fact that only complicated cases of AD come to surgery, where the presence of chronic cholecystitis or calculi detracts from recognising or overshadows the presence of AD. It is not known whether uncomplicated AD has any clinical significance and whether it, if given sufficient time, will lead to inflammation of the gall bladder.