Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
BMC Gastroenterol. 2011 Oct 5;11:106. doi: 10.1186/1471-230X-11-106.
Gallbladder adenomyomatosis is a benign condition characterized by hyperplastic change in the gallbladder wall and overgrowth of the mucosa because of an unknown cause. Patients with gallbladder adenomyomatosis usually present with abdominal pain. However, we herein describe a case of a patient with gallbladder adenomyomatosis who did not present with abdominal pain, but with only fever.
A 34-year-old man presented to our hospital with a fever. No abdominal discomfort was declared. His physical examination showed no abnormalities. Ultrasound of the abdomen revealed thickness of the gallbladder. Acute cholecystitis was diagnosed. The fever persisted even after 1 week of antibiotic therapy. Magnetic resonance imaging of the abdomen showed gallbladder adenomyomatosis with intramural Rokitansky-Aschoff sinuses. Exploratory laparotomy with cholecystectomy was performed. The fever recovered and no residual symptoms were reported at the 3-year follow-up.
Gallbladder adenomyomatosis can present with fever as the only symptom. Although the association between gallbladder adenomyomatosis and malignancy has yet to be elucidated, previous reports have shown a strong association between gallbladder carcinoma and a subtype of gallbladder adenomyomatosis. Surgical intervention remains the first-choice treatment for patients with gallbladder adenomyomatosis.
胆囊腺肌症是一种良性疾病，其特征为胆囊壁的增生性改变和黏膜过度生长，原因不明。胆囊腺肌症患者通常表现为腹痛。然而，我们在此描述了一例胆囊腺肌症患者，其仅表现为发热，无腹痛。
一名 34 岁男性因发热就诊。患者未诉腹部不适。体格检查未见异常。腹部超声显示胆囊壁增厚。诊断为急性胆囊炎。尽管给予了 1 周的抗生素治疗，但发热仍持续存在。腹部磁共振成像显示胆囊腺肌症伴壁内罗基坦斯基-阿绍夫窦。行剖腹探查术和胆囊切除术。发热恢复，3 年随访时无残留症状。
胆囊腺肌症可仅以发热为唯一症状。虽然胆囊腺肌症与恶性肿瘤之间的关联尚未阐明，但之前的报告显示胆囊腺癌与胆囊腺肌症的一种亚型之间存在很强的关联。手术干预仍然是胆囊腺肌症患者的首选治疗方法。
