First AD

Second AD

A 45-year-old woman presents with abdominal pain in the right upper quadrant (RUQ) that is unrelated to meals. She undergoes a RUQ ultrasound which does not reveal any gallstones, but incidentally notes a 2.5-cm polyp in the gallbladder.

C. Endoscopic retrograde cholangiopancreatography

D.  Hepatobiliary iminodiacetic acid scan 

Imaging studies cannot distinguish benign from malignant polyps based on appearance. Most polyps measuring less than 1 cm are benign; the risk of malignancy increases with size. Gallbladder polyps measuring greater than 2 cm may be neoplastic, and therefore an elective cholecystectomy is recommended, especially since gallbladder cancer has a very poor prognosis.

Gastrointestinal Disorders

No gallstones were found on RUQ ultrasound in this 45-year-old patient, but a polyp was seen. How would you proceed? 

Incidental Gallbladder Polyp: What Does Size Say About Next Steps?