ENDOSCOPIC ULTRASONOGRAPHIC DIAGNOSIS OF ADENOMYOMATOSIS OF THE GALLBLADDER

WITH SPECIAL REFERENCE TO THE COMPARISON WITH CHRONIC CHOLECYSTITIS

Abstract

Endoscopic ultrasonographic findings of three patients with generalized or segmental type of adenomyomatosis of the gallbladder were compared with those of four patients with chronic cholecystitis.The main part of the wall thickness of adenomyomatosis of the gallbladder was in the second low echoic layer, whereas that of chronic cholecystitis was in the third high echoic layer ; these endoscopic ultrasonographic findings were in agreement with the thickened muscular layer and subserosal layer, respectively.Small cystic echos occasionally containing a fine high echo spot were seen in the second low echoic layer in the patients with adenomyomatosis of the gallbladder. These findings were consistent with dilated Rokitansky-Aschof f sinus and intramural stone. The border between the second and third layer was wavy in the patients with adenomyomatosis of the gallbladder, whereas that in chronic cholecystitis was relatively clear.This result suggests that adenomyomatosis of the gallbladder can be diagnosed qualitatively on the basis of endoscopic ultrasonographic findings.