Perisić-Savić M, Colović R, Jancić-Zguricas M
Acta Chir Iugosl. 1990;37(2):189-98.
Adenomyomatosis is a rare benign proliferative disease of the gallbladder characterized by epithelial proliferation and formation of mucosal pouches through the thickened muscular layer of gall bladder wall. It appears in three different types: diffuse, segmental and localised adenomyomatosis. Diffuse type is the rarest. Etiology is unknown. Patients sometimes feel a dull pain in the upper right abdominal quadrant. Preoperative diagnosis is based on cholecystography and ultrasonography. Cholecystectomy is a method of treatment. Diagnosis is confirmed on histology. Very rarely, adenomyomatosis seems to bee a premalignant condition. We present four patients treated during the last two years, a woman and three men, 27-41 years old (average 37 years). All these patients had a dull pain in the right subcostal region, approximately 6 months before the diagnosis was established. One patient had chronic alcoholic pancreatitis with dilated pancreatic duct. Diagnosis of diffuse adenomyomatosis was made preoperatively on ultrasonography in all patients. Cholecystectomy was carried out Diagnosis was confirmed on histology. There was no carcinoma. In a patient with chronic pancreatitis Wirsungojejunostomy (Puestow) and choledochojejunostomy were also carried out.
腺肌增生症是一种罕见的胆囊良性增生性疾病，其特征为上皮增生以及通过胆囊壁增厚的肌层形成黏膜袋。它有三种不同类型：弥漫型、节段型和局限型腺肌增生症。弥漫型最为罕见。病因不明。患者有时会感到右上腹隐痛。术前诊断基于胆囊造影和超声检查。胆囊切除术是一种治疗方法。组织学检查可确诊。极少数情况下，腺肌增生症似乎是一种癌前病变。我们呈现过去两年间治疗的4例患者，1名女性和3名男性，年龄在27至41岁之间（平均37岁）。所有这些患者在确诊前约6个月均有右肋下区域隐痛。1例患者患有慢性酒精性胰腺炎且胰管扩张。所有患者术前通过超声检查诊断为弥漫型腺肌增生症。实施了胆囊切除术，组织学检查确诊。无癌变。对1例患有慢性胰腺炎的患者还实施了胰管空肠吻合术（普斯托手术）和胆总管空肠吻合术。
