Objective:

Gallbladder adenomyomatosis (ADM) is a rare disease in pediatrics, characterized by epithelial proliferation and muscle hypertrophy, associated with the formation of fistulous tracts, classically called Rokitansky-Aschoff sinuses. It is an anatomical and clinical entity that is difficult to diagnose. Ultrasound is the primary diagnostic tool, but ADM is confirmed by its characteristic histological findings.

Clinical case:

A 15-year-old adolescent with a previous diagnosis of congenital scoliosis and hemivertebra at T11-12 with secondary spinal cord compression and butterfly vertebrae at T5-L3 was admitted for surgical management of this entity. In the immediate postoperative period, band-like abdominal pain and elevated pancreatic enzymes were present, considering the initial diagnosis of acute pancreatitis. Imaging studies revealed a thickened gallbladder with increased size and findings compatible with gallbladder ADM. The patient showed improvement in symptoms after undergoing laparoscopic cholecystectomy. The diagnosis of gallbladder ADM was later confirmed by histology.

Conclusion:

Gallbladder ADM is extremely rare in children; little is known about its pathogenesis and pathology. It is diagnosed mainly by ultrasound, which identifies hypertrophy of the muscular layer and the formation of fistulous tracts, known as Rokitansky-Aschoff sinuses.

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