1. Ultrasound Division, ASL Roma B, Rome, Italy;
2. Ultrasound Division, Ceprano Hospital, Ceprano, Italy.

Case report

Following images and video show a fetus at 38 weeks with hyperechoic walls of the gallbladder. No material was present within its lumen.

Although the hyperechoic-walled gallbladder may be sometime seen during prenatal ultrasound, explanation of this prenatal finding has been rarely described in the literature so far. Possible explanation of the hyperechogenicity of the gallbladder walls is adenomyomatosis of the gallbladder.

Gallbladder adenomyomatosis has been commonly described in adult patients, but we have found only one article describing the finding in fetal period [1]. 

As it is usually not possible to obtain histopathological evidence in such cases, the diagnosis is of the fetal gallbladder adenomyomatosis represents just a possible explanation of hyperechoic appearance of the gallbladder walls.

The part of the image showing the histopathological specimen demonstrating adenomyomatosis of the gallbladder was obtained from Wikimedia commons website: 
http://commons.wikimedia.org/wiki/File:Adenomyomatous_hyperplasia_of_the_gallbladder,_HE_2.JPG

References

1. MP Bethune, M Pahuja. Adenomyomatosis causing an echogenic fetal gallbladder – a new association. Ultrasound Obstet Gynecol, 18: P96. doi: 10.1046/j.1469-0705.2001