Acute inflammatory dilation of the cystic duct induced by a stone.

cystic duct and stone removal were performed under a preoperative diagnosis of chronic cholecystitis (adenomyomatosis) and stone-induced dilated cystic duct. Macroscopically, the gallbladder showed chronic cholecystitis with segmental adenomyomatosis ( fig. 2 ). The cystic duct retained the spiral valve, but was significantly dilated with wall thickening. Histopathologically, chronic cholecystitis with increased Rokitansky-Aschoff sinuses and severe infiltration of neutrophils and macrophages in the cystic duct led to diagnosis of acute inflammatory expansion of the cystic duct. The patient is doing well 6 months postoperatively. The mean inside diameter of the cystic duct is 3 mm and the frequency of dilated cystic duct ( 1 1 cm) induced by a stone is less than 1%. Dilation of 1 2 cm has not been reported. A 55-year-old woman in whom gallstone-induced chronic cholecystitis had been followed for more than 10 years was referred to our hospital. On admission, she had a positive Murphy’s sign with low-grade fever. Magnetic resonance cholangiopancreatography demonstrated adenomyomatosis at the neck and fundus of the gallbladder and a stone in the cystic duct ( fig. 1 ). The cystic duct distal to the stone was dilated by 1 2 cm in diameter. Open cholecystectomy with resection of the dilated Published online: September 26, 2008