Gallbladder Adenomyomatosis
Gallbladder adenomyomatosis is a benign (non-cancerous) condition in which the gallbladder wall becomes thickened due to overgrowth of its lining and muscle layer. This process forms tiny pockets called Rokitansky–Aschoff sinuses within the gallbladder wall. The condition is often discovered incidentally during imaging performed for abdominal pain or unrelated reasons and typically does not cause symptoms on its own.
What is it?
Gallbladder adenomyomatosis develops when the inner lining and muscle layer of the gallbladder become thickened, creating small pockets that can trap bile. These pockets, known as Rokitansky–Aschoff sinuses, often contain cholesterol crystals that produce “comet-tail” artifacts on ultrasound—bright trailing echoes that help radiologists recognize this condition. Gallbladder adenomyomatosis is benign and not associated with gallbladder cancer, although atypical appearances may prompt additional evaluation.
The condition is frequently discovered when imaging is performed to assess abdominal pain, suspected gallstones, or other gastrointestinal concerns. It can involve a small area (focal), a section of the gallbladder (segmental), or the entire wall (diffuse).
Important to Know
Most people with gallbladder adenomyomatosis do not require treatment, especially when they have no symptoms. Because its appearance can mimic other conditions such as gallbladder polyps, inflammation, or—rarely—gallbladder cancer, radiologists look for characteristic signs like comet-tail artifacts or specific wall thickening patterns on CT or MRI to confirm the diagnosis.
If symptoms such as persistent right upper abdominal pain or nausea occur, further evaluation may be recommended. Gallbladder removal (cholecystectomy) may be considered if discomfort continues or if the diagnosis remains uncertain. Follow-up imaging may be used to ensure the findings remain stable over time.