The “honeycomb” gallbladder

Excerpt

A bee’s honeycomb (Fig. 1) has been used to metaphorically describe the sonographic imaging appearance of a multiseptated gallbladder [1]. This rare anomaly is produced by a thickened gallbladder wall with numerous non-shadowing echogenic septa crisscrossing the lumen (Fig. 2). Histologically, these septations consist of epithelial layers with an interposed muscular layer [2]. The etiology of the multiple septations is uncertain, but favored embryologic theories include a failure of the solid gallbladder bud to fully cavitate/vacuolize, persistent wrinkling (as seen in animal models), or gallbladder bud growth that outpaces the bed resulting in coiling or kinking [3]. The honeycomb gallbladder may also be acquired, possibly secondary to chronic inflammation [4].

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