A case of the rapid growth gallbladder adenoma with cholangitis

Abstract

A 84-year-old man had postprandial nausea, epigastralgia and fervescence, and he was admitted to our hospital with diagnosis of cholangitis. Abdominal ultrasonography revealed a polyp whose diameter was 12 millimeters in the gallbladder, and contrast ultrasonograhy demonstrated the polyp was well vascularised. Cholangitis promptly improved. Clinical progress was similar to the passing of gallstones, but ultrasonography didn't reveal gallstones. It was suggested cholangitis was caused by the spontaneous detachment of the polyp. Because of old age, we didn't practice a surgical therapy, but follow-up ultrasonography revealed the polyp which increased to 24 millimeters. We considered the polyp may be malignant, and open cholecystectomy was performed. Pathological examination revealed the pedunculated polyp was villotubular adenoma. The trace of bleeding suggested a possibility of the spontaneous detachment of the gallbladder polyp.