strawberry gallbladder

The strawberry gallbladder, also known as cholesterolosis or hyperplastic cholecystoses, is a condition characterized by an abnormal accumulation of cholesterol in the gallbladder wall. This leads to the formation of polyps and a stippled appearance on the mucosal surface, resembling the surface of a strawberry.

Key Features:

• The mucosal surface has a stippled or speckled appearance, similar to a strawberry.
• Cholesterol accumulates in the gallbladder wall, forming polyps.
• The condition is usually benign and asymptomatic.
• It may cause complications such as gallstones, inflammation, and cholecystitis.

Pathogenesis:

• The exact pathogenesis of cholesterolosis is still not known.
• It is believed to be related to lipid metabolism disorders.
• Factors such as obesity, smoking, and alcohol history may contribute to the development of this condition.

Gross Examination:

• The gallbladder mucosa has a reddening and granular appearance.
• Yellow micropolyps (1-2 mm) are visible on the surface, contrasting with the red surrounding mucosa.

Histological Features:

• Foamy macrophages are present in the lamina propria and epithelium.
• The gallbladder wall shows hyperplasia of the mucosa and muscularis propria.

The strawberry gallbladder is a unique cholecystopathy that can be diagnosed through gross examination and histological analysis. It is essential to differentiate this condition from other gallbladder pathologies, such as adenomyomatosis or polyps. [1][2][3][4][5]

Symptoms of Strawberry Gallbladder

The symptoms of strawberry gallbladder, also known as cholesterolosis of the gallbladder, can vary from person to person. However, some common signs and symptoms include:

• Abdominal pain: Mild to severe pain in the upper right or center abdomen, which may radiate to the back or right shoulder [5][7].
• Fever: Some people may experience fever as a symptom of strawberry gallbladder [5][7].
• Nausea and vomiting: Nausea and vomiting can occur due to the inflammation and irritation caused by the cholesterol deposits in the gallbladder [5][7].
• Jaundice: In some cases, jaundice (yellowing of the skin and eyes) may be a symptom of strawberry gallbladder [7].

It's worth noting that many people with strawberry gallbladder do not experience any symptoms at all. The condition is often found incidentally during diagnostic imaging for other reasons.

Macroscopic appearance

The surface appearance of the gallbladder in cases of strawberry gallbladder can be described as follows:

• Yellow flecks: Macroscopically, lipid deposits appear as yellow flecks against a dark yellow to green background [6].
• Focal or diffuse flat yellowish dots: The gross feature of focal or diffuse flat yellowish dots on the lining of the gallbladder is also known as strawberry gallbladder [8].

It's essential to consult a healthcare professional for an accurate diagnosis and treatment plan if you suspect you have strawberry gallbladder.

References:

[5] - Symptoms of Gallbladder Problems. [6] - Jun 30, 2023 — Macroscopically lipid deposits appear as yellow flecks against dark yellow to green background, thus earning the nickname 'Strawberry ... [7] - Abdominal pain. Fever. Nausea and vomiting. Jaundice. More rarely, these symptoms may also indicate gallbladder cancer. What causes gallbladder polyps? [8] - Jan 16, 2024 — Gross feature: focal or diffuse flat yellowish dots on the lining of the gallbladder. Terminology: Also known as strawberry gallbladder.

Diagnostic Tests for Strawberry Gallbladder

The diagnostic tests for strawberry gallbladder, also known as cholesterolosis, typically involve imaging studies to assess the condition and cholesterol deposits in the gallbladder.

• Ultrasound: An abdominal ultrasound is often used to diagnose strawberry gallbladder. It is a non-invasive test that can detect the accumulation of cholesterol esters and triglycerides in the gallbladder wall, as well as other complications such as gallstones or inflammation [5].
• Endoscopic Ultrasonography (EUS): EUS may also be used to diagnose strawberry gallbladder, particularly if the ultrasound results are inconclusive. This test uses a flexible tube with an ultrasound probe on the end to visualize the gallbladder and surrounding tissues [5].
• Imaging Studies: Other imaging studies such as computed tomography (CT) scans or magnetic resonance cholangiopancreatography (MRCP) may also be used to diagnose strawberry gallbladder, although these tests are typically reserved for more complex cases [10].

Blood Tests

While blood tests cannot directly diagnose strawberry gallbladder, they can help identify other conditions that may be associated with the condition. For example, blood tests may show raised levels of cholesterol LDL, alanine transferase, and gamma-glutamyl transferase [8].

Other Diagnostic Tests

In some cases, additional diagnostic tests such

Treatment Options for Strawberry Gallbladder

The treatment options for strawberry gallbladder, also known as cholesterolosis or polypoid cholecystosis, are generally focused on managing symptoms and preventing complications.

• No specific drug treatment: There is no specific medication that can treat strawberry gallbladder. However, some medications may be used to manage associated conditions.
• Octreotide: Octreotide, a long-acting somatostatin analog, has been used in some cases to reduce the size of polyps and alleviate symptoms [8]. However, its effectiveness is not well established, and more research is needed to confirm its benefits.

Other Treatment Options

While drug treatment may not be effective for strawberry gallbladder, other treatment options are available:

• Surgery: In some cases, surgery may be necessary to remove the gallbladder (cholecystectomy) if symptoms persist or complications arise [3][4].
• Observation: If polyps are small and asymptomatic, a wait-and-watch approach may be recommended, with regular follow-up appointments to monitor for any changes [6].

Important Note

It's essential to consult a healthcare professional for personalized advice on managing strawberry gallbladder. They can assess individual circumstances and provide guidance on the best course of action.

References:

[8] Octreotide. As a long-acting somatostatin analog, octreotide is used as chronic therapy for acromegaly and various other gastrointestinal disorders. [3] Surgery: While it might seem severe, gallbladder removal is the only known treatment for gallbladder diseases. If your polyps come with inflammation or with ... [4] by ON Dilek · 2019 · Cited by 61 — The most common treatment approach is to perform cholecystectomy in patients with polyps larger than 10 mm in diameter. [6] Feb 21, 2023 — INTRODUCTION. Gallbladder polyps are outgrowths of the gallbladder mucosal wall. They are usually found incidentally on ultrasonography or ...

The differential diagnosis for strawberry gallbladder, also known as cholesterolosis, involves considering other conditions that may present similarly.

• Adenomyomatosis: This is another rare gallbladder disease that should be considered a differential diagnosis for cholesterolosis. Compared to strawberry gallbladder, adenomyomatosis is characterized by the presence of hyperplasia and in-folding of the gallbladder lining which lead to the formation of Rokitansky-Aschoff sinuses [11].
• Gallbladder carcinoma: This is a type of cancer that can affect the gallbladder and may present with similar symptoms to strawberry gallbladder.
• Phrygian cap: This is a normal variant appearance of the gallbladder, but it can be mistaken for other conditions such as adenomyomatosis or cholesterolosis.
• Gallbladder polyp (cholesterol polyp): This is a type of polyp that forms on the wall of the gallbladder and may be confused with strawberry gallbladder.

It's worth noting that differential diagnosis for strawberry gallbladder can be challenging, and a definitive diagnosis often requires histopathological examination [10].

References: [10] Adenomyomatosis is another gallbladder rare disease that should be considered as a differential diagnosis with cholesterolosis. Compared to strawberry gallbladder, adenomyomatosis is characterized by the presence of hyperplasia and in-folding of the gallbladder lining which lead to the formation of Rokitansky-Aschoff sinuses [14]. [11] Adenomyomatosis is another gallbladder rare disease that should be considered as a differential diagnosis with cholesterolosis. Compared to strawberry gallbladder, adenomyomatosis is characterized by the presence of hyperplasia and in-folding of the gallbladder lining which lead to the formation of Rokitansky-Aschoff sinuses [14]. [14] Adenomyomatosis is another gallbladder rare disease that should be considered as a differential diagnosis with cholesterolosis. Compared to strawberry gallbladder, adenomyomatosis is characterized by the presence of hyperplasia and in-folding of the gallbladder lining which lead to the formation of Rokitansky-Aschoff sinuses [14].