The presence of outpocketings of the gall bladder mucosa communicating with the lumen has been described by pathologists for almost 100 years. There has been considerable confusion concerning the histologic appearance, the mode of formation, and the pathologic significance of these pockets.
Rokitansky-Aschoff sinuses or cystitis glandularis proliferans refer to gall bladder diverticula. These protrusions of gall bladder mucosa through the muscular layer of the wall result from a weakness of the muscular layer together with an increased intraluminal pressure. Absence of a muscularis mucosa, sparseness of muscle fibers, and frequent piercing of the muscularis by blood vessels create the potential spaces for herniation of mucosa under the influence of disease. Inflammatory disease and increased intracystic tension from obstruction or neurogenic dysfunction are conditions which favor the occurrence of herniation.
These diverticula occur frequently, as demonstrated by Robertson and Ferguson,1 who found them in half of the surgical specimens