Ultrasound ‘gallbladder polyps’: a misleading description best rephrased

Introduction Management of an ultrasound diagnosis of gallbladder ‘polyp’ (GBP) involves balancing the risk of missed adenoma with patient anxiety of ‘polyp’ suggesting malignant risk. Radiological reports often lack detail to stratify risk. This study describes the state of ultrasound reporting of GBPs in metropolitan practice. Method Retrospective review of a single surgeon's database was carried out (1999–2013). Patient demographics, symptoms and histopathological findings were reviewed. Radiological reports were examined for size, mobility, echogenicity and vascular flow within the polyp. Results Sixty-three patients were referred with GBP diagnosis. Twenty-eight did not progress to surgery. Patients with available pathology were distributed: 11 (31%) cholesterol ‘polyps’ and 2 (8%) true adenomatous polyps. Original ultrasound report was available in 21 patients. Reports recorded ‘polyp’ size in 15 (71%), mobility in 9 (43%), echogenicity in 6 (29%) and vascular flow in 1 (5%). The number was reported in 16 (57%). Discussion Ultrasound is not a specific test for biliary adenoma and frequently misinterprets stones or adenomyosis as ‘polyp’. Reports often did not provide enough detail for informed judgement for advice about cholecystectomy. To avoid unnecessary patient concern, it is suggested the term ‘polyp’ be abandoned for ‘echogenic focus with or without likelihood of adenoma’.