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Honeycomb gallbladder or multi-septated gallbladder is a rare congenital abnormality categorized as a gallbladder shape variant.

Clinical presentation is variable, ranging from asymptomatic to chronic pain in the right upper quadrant and cholecystitis.

Its pathogenesis is not clearly identified. One theory is that there is incomplete cavitation of the gallbladder in its solid embryologic form [1].

Ultrasonographic findings include multiple thin intraluminal and hyper echogenic septa within the gallbladder, delineating hypoechogenic cavities giving a “honeycomb” appearance (Figure 1)

Figure 1: B-mode abdominal ultrasound scan of a 2 years old girl with Down's syndrome (A: long axis view, B: short axis view) shows multiple septations in the gallbladder (green arrow), delineating hypoechogenic cavities giving a "honeycomb" appearance. Moreover, there is no parietal thickening or stones in the lumen.

The differential diagnosis includes necrotizing cholecystitis, adenomyomatosis or hydatid cyst.

Multiseptated gallbladder is considered a benign disorder [2]. The indications for cholecystectomy include cholelithiasis, cholecystitis and gallstone pancreatitis.

1. Simon M, Tandon BN (1963) . A case report. Radiology 80: 84-86.

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2. Wanaguru D, Jiwane A, Day AS, Adams S (2011) . Case Rep Gastrointest Med 2011: 470658.

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