‘Strawberry gall bladder’:
Correct Answer: Cholesterosis
Description: Ans. a (Cholesterosis). (Ref. Bailey & Love Surgery 25th/ pg. Fig. 63.28)TERMFEATURESGB polypIncidental findings. Size > 10 mm is an indication for prophylactic cholecystectomy as risk of malignancy is high then. USG is best to monitor polyp size.Cholesterosis ('strawberry gall bladder')It is chronic inflammatory changes with hyperplasia of all tissue elements comprising of cholesterosis (Submucous aggregations of cholesterol crystals & esters giving "Strawberry like" appearance to GB)deg, cholesterol polyposis of GB (cholesterol or adenomatous polyposis) & cholecystitis glandularis proliferans (Polyp or adenomyomatosis or intramural diverticulosis of mucous membrane of GB affecting all layers with mixed calculi, treated with cholecystectomy).In the fresh state, the interior of the gall bladder looks something like a strawberry; the yellow specks (submucous aggregations of cholesterol crystals and cholesterol esters) correspond to the seeds. It may be associated with cholesterol stones.Diverticulosis of GBusually manifest as black pigment stones impacted in the out pouching of lacunae of Luschka.Cholecystitis glandularis proliferansIt is chronic inflamation with hyperplasia of GB Wall.It is premalignant lesion.Adenomyomatosis of GBHistologicaly Characteristic feature is Rokytanski Aschof sinuses.On USG it is seen as diffuse/focal wall thickening of GB with high amplitude artefacts and positive "comet-tail" sign. 0Porcelain gall bladderIt is calcification of gall bladder wall (Premalignant condition).0
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