The focus on the right is difficult to identify as lying between muscle bundles. There is no desmoplasia, but some gallbladder adenocarcinomas show little recognizable desmoplasia. Note again the predominant extension between muscle bundles, recognizable by the stroma about the sinuses, some of which are branched, pushing the muscle wall aside. The mucosa shows extensive reactive branching. Note the longitudinal extensions of the Rokitansky-Aschoff sinuses, as well as the ballooning outside the wall at lower right. In between the gall stone at lower left and the lymphoid aggregate at upper right lies the gallbladder wall.
Note their travel in between muscle bundles can be recognized as continuity to the surface. Extending from a benign, chronically inflamed plicae are Rikitansky-Aschoff sinuses. Intestinal metaplasia of the gallbladder - goblet cells present, may be focal.Įxtensive Rokitansky-Aschoff sinuses in a 64 year ood woman.Cholecystectomy for gallstone pancreatitis - intraepithelial neutrophil clusters common, history essential.Acute cholecystitis - more inflammation, lack Rokitansky-Aschoff sinuses, +/-mucosal erosions.Gallbladder cholesterolosis and chronic cholecystitis.+/-Foamy macrophages in the lamina propria ( cholesterolosis of the gallbladder).Entrapped epithelial crypts - pockets of epithelium in the wall of the gallbladder.
Positive Murphy's sign (physical exam, with ultrasound).Constant right upper quadrant pain after a fatty meal (biliary colic).Female, fat, fertile, family history, forty (though now getting younger.You can call today for an appointment to discuss current injury treatments, injury prevention and sports performance concerns.Ĭlick here for patient handout and condition information.Ĭlick here for updated posts and news articles. Kevin Mangum is a highly trained board certified sports medicine and family medicine physician who loves to treat athletes from all ages and sports. His office is very convenient to patients to find and visit.ĭr. Mangum works at Foothill Family Clinic, and his office is in Salt Lake City, Utah off of foothill drive. Kevin Mangum treats all patients and athletes, from low to elite functioning. Kevin Mangum uses a wide variety of techniques, treatments and therapies to manage non-operative orthopedic sport related injuries including diagnostic ultrasound, therapeutic ultrasound procedures, platelet rich plasma (PRP), percutaneous needle tenotomy, hyaluronic Injections, corticosteroid Injections, prolotherapy, ultrasound guided tendon barbotage for calcific tendonitis, epidural steroid injections and many other modalities. is a Utah sports medicine and family medicine physician who treats non-operative orthopedic conditions including neck pain, back pain, shoulder pain, elbow pain, wrist pain, hip pain, knee pain, ankle pain, broken bones (fractures), tendon injuries, ligament injuries, concussions and many other sport related injuries.ĭr.
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