Reporte de Caso

Adenomiomatosis Vesicular Diagnosticado por Ultrasonido. Reporte de Un Caso Clínico

Jonathan Dazaeth Delgado-Sánchez1, Erick Israel González-Campos2, Estefanía-Montserrat Quezada-Ávila3, Karen Verónica Moreno-Casillas4, Lesly Manelli Lara-Ruiz5, Luis Ángel Gutiérrez-Estrada6, Raú Gamboa-Solís7
Publicado 2022-03-01 | CIMMEF 2022;1:36-42
Vol. 1 Núm. 1 (2022)
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Revista Cientifica Mexicana de Médicos en Formación
Vol. 1 • Núm. 1 • 2022-03-04
Páginas: 36-42
Derechos de autor
Creative Commons License

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.

Derechos de autor 2022 Revista Cientifica Mexicana de Médicos en Formación

Historial
Publicado en línea: 2022-03-01
Publicado en el número: 2022-03-04

Resumen

La adenomiomatosis de la vesícula biliar se considera un padecimiento benigno y poco frecuente, con una incidencia aproximada de 2.8-5 %; normalmente es diagnosticada a partir de los 50 a los 60 años, contando con una distribución mayor en mujeres que en hombres. Frecuentemente, los pacientes presentan cuadros clínicos asintomáticos o síntomas inespecíficos (dolor abdominal difuso, náuseas, vómitos, etc.), logrando que esta enfermedad pase desapercibida y sea detectada hasta que se realizan los estudios complementarios para la evaluación del padecimiento de manera incidental; la detección primaria se hace por ultrasonografía. Existen características específicas que sugieren esta lesión, aunque es difícil hacer un diagnóstico definitivo por este estudio, ya que las imágenes pueden ser inespecíficas e imitar malignidad; la resonancia magnética se considera el estándar de oro para el diagnóstico. Si el paciente se presenta asintomático, será suficiente un tratamiento conservador, realizando dos ultrasonidos por año. En cambio, si el paciente presenta síntomas, se debe de considerar la colecistectomía laparoscópica.

En este artículo, se presenta el caso de un paciente masculino de 74 años de edad con adenomiomatosis de vesícula biliar manejada con tratamiento conservador, en donde se aborda la importancia de individualizar el manejo en los casos asintomáticos o cuando el abordaje quirúrgico no es una opción. Se reporta el caso de un hombre de 74 años que acude al servicio de imagenología de una unidad privada por referencia del médico familiar, al presentar dolor en hipocondrio derecho y distensión abdominal de un mes de evolución que aumenta con el consumo de alimentos colecistoquineticos. 

Las pruebas de laboratorio, incluyendo AFP, CA19-9, CEA, SGOT, SGPT, bilirrubina, transaminasas y fosfatasa alcalina estaban dentro de los límites normales. El ultrasonido reveló una masa sólida hipoecoica con límites borrosos y superficie irregular, se observó un engrosamiento de la pared de la vesícula biliar, senos de Rokitansky-Aschoff, y artefactos en cola de cometa, lo cual es consistente con adenomiomatosis de vesícula biliar de tipo difuso.

Palabras clave

Adenomiomatosis de la vesícula biliar, Vesícula biliar, Senos de Rokitansky-Aschof, Reporte de Caso

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