Case Report

Intramural Gallstones Mimicking Typical Lithiasic Cholecystitis

Authors: Stylianos Apostolidis, MD, PhD, Apostolos Zatagias, MD, Alexandros Zevgaridis, MD

Abstract

Gallstone disease is common in the western population. Intramural gallstones are rare, with only a few cases reported in the literature. We present a 30-year-old female patient with typical symptoms of cholecystitis. The patient underwent laparoscopic cholecystectomy one month later. Dark greenish intramural gallstones were identified right after the resection of the gallbladder, and the pathologic examination revealed adenomyomatosis of the gallbladder. To our knowledge, this is the first report of intramural gallstones presenting with cholecystitis. The presence of intramural gallstones is not easily detected during ultrasound examination, and does not affect the natural course or treatment of gallstone disease.

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References

1. Moore SW. Intramural formation of gallstones. Arch Surg 1937;34:410–423.
 
2. Kawanishi K, Nishimura F. Intramural pure pigment gallstones. A case report. Acta Med Okayama1963;17:203–207.
 
3. Mizuno T, Masaoka A, Honda K, et al. Intramural giant gallstone: report of a rare case. Am J Gastroenterol 1987;82:454–456.
 
4. Iwamura K, Ueno F. Laparoscopic finding of the gallbladder in a case of intramural gallstones.Gastroenterol Jpn 1978;13:442–446.
 
5. Harris HW. Biliary System, in Norton JA (ed): Surgery: Basic Science and Clinical Evidence. New York, NY, Springer-Verlag, 2001, pp 553–584.
 
6. Adsay NV. Alimentary Canal and Associated Organs, in Mills S (ed): Sternberg's Diagnostic Surgical Pathology. Philadelphia, PA, Lippincott Williams and Wilkins, 2004, ed 4, pp 1175–1828.
 
7. Fowler RC, Reid WA. Ultrasound diagnosis of adenomyomatosis of the gall-bladder: ultrasonic and pathological correlation. Clin Radiol 1988;39:402–406.