Diffuse gallbladder wall thickening (differential)

Changed by Mostafa Elfeky, 1 Jul 2022

Back to revision history

Disclosures - updated 11 May 2022: Nothing to disclose

Updates to Article Attributes

Body was changed:

Show markup changes

Diffuse thickening of the gallbladder wall can occur in a number of situations:

cholecystitis
- acute cholecystitis
- chronic cholecystitis
- gallbladder empyema ⁷
- xanthogranulomatous cholecystitis¹¹
- acalculous cholecystitis ¹¹
postprandial physiological state (pseudothickening)
- gallbladder overall decompressed
secondary thickening
- hepatic cirrhosis
- hepatitis
- congestive right heart failure
- Fitz-Hugh-Curtis syndrome
- hypoalbuminaemia ⁶
- ascites^9,15,12
- other acute inflammatory processes in the right upper quadrant
  - acute pancreatitis
  - perforated duodenal ulcer ⁸
  - acute pyelonephritis ¹⁶¹⁵
  - peritonitis ¹³¹²
- primary sclerosing cholangitis ^10,11
  - rarely a direct cause - mostly in the setting of concurrent ~~hypoalbuminemia~~hypoalbuminaemia and/or liver failure
  - gallbladder wall thickening related to involvement of primary sclerosing cholangitis is controversial ¹⁰
- gallbladder perforation ⁹
- brucellosis ¹¹
- AIDS cholangiopathy ⁹
- severe pyelonephritis ¹³¹²
- renal failure ¹¹
gallbladder carcinoma
- a minority present as focal or diffuse wall thickening (20-30%)^11,12
- suspicious features include marked asymmetric wall thickening and irregularity ¹²
diffuse adenomyomatosis of the gallbladder
- associated with classic comet tail artifact ¹¹
- associated with epithelial enhancement on CT ¹¹
haemophagocytic lymphohistiocytosis (HLH) ¹⁴¹³

~~-<a href="/articles/ascites">ascites</a> 9,15~~
+<a href="/articles/ascites">ascites</a> 9,12
~~-<a href="/articles/acute-pyelonephritis-1">acute pyelonephritis</a> 16~~
+<a href="/articles/acute-pyelonephritis-1">acute pyelonephritis</a> 15
~~-<li>peritonitis 13~~
+<li>peritonitis 12
~~-<li>rarely a direct cause - mostly in the setting of concurrent hypoalbuminemia and/or liver failure</li>~~
+<li>rarely a direct cause - mostly in the setting of concurrent hypoalbuminaemia and/or liver failure</li>
~~-<li>severe <a href="/articles/pyelonephritis">pyelonephritis</a> 13~~
+<li>severe <a href="/articles/pyelonephritis">pyelonephritis</a> 12
~~-<a href="/articles/haemophagocytic-lymphohistiocytosis-hlh">haemophagocytic lymphohistiocytosis (HLH)</a> 14~~
+<a href="/articles/haemophagocytic-lymphohistiocytosis-hlh">haemophagocytic lymphohistiocytosis (HLH)</a> 13

References changed:

9. Wolfgang Dähnert. Radiology Review Manual. (2011) ISBN: 9781451118124 - <a href="http://books.google.com/books?vid=ISBN9781451118124">Google Books</a>
11. Wolfgang F. Dahnert. Radiology Review Manual. (2017) ISBN: 9781496360694 - <a href="http://books.google.com/books?vid=ISBN9781496360694">Google Books</a>
12. Runner G, Corwin M, Siewert B, Eisenberg R. Gallbladder Wall Thickening. AJR Am J Roentgenol. 2014;202(1):W1-W12. <a href="https://doi.org/10.2214/ajr.12.10386">doi:10.2214/ajr.12.10386</a>
13. Schmidt M, Sung L, Shuckett B. Hemophagocytic Lymphohistiocytosis in Children: Abdominal US Findings Within 1 Week of Presentation. Radiology. 2004;230(3):685-9. <a href="https://doi.org/10.1148/radiol.2303030223">doi:10.1148/radiol.2303030223</a>
14. Colli A, Cocciolo M, Buccino G et al. Thickening of the Gallbladder Wall in Ascites. J Clin Ultrasound. 1991;19(6):357-9. <a href="https://doi.org/10.1002/jcu.1870190606">doi:10.1002/jcu.1870190606</a>
15. Zissin R, Osadchy A, Gayer G, Kitay-Cohen Y. Extrarenal Manifestations of Severe Acute Pyelonephritis: CT Findings in 21 Cases. Emerg Radiol. 2006;13(2):73-7. <a href="https://doi.org/10.1007/s10140-006-0503-y">doi:10.1007/s10140-006-0503-y</a>
16. Levy A, Murakata L, Rohrmann C. Gallbladder Carcinoma: Radiologic-Pathologic Correlation. Radiographics. 2001;21(2):295-314. <a href="https://doi.org/10.1148/radiographics.21.2.g01mr16295">doi:10.1148/radiographics.21.2.g01mr16295</a>
9. Wolfgang Dähnert. Radiology Review Manual. (2011) ISBN: 9781451118124
11. Wolfgang F. Dahnert. Radiology Review Manual. (2017) ISBN: 9781496360694
13. Runner G, Corwin M, Siewert B, Eisenberg R. Gallbladder Wall Thickening. AJR Am J Roentgenol. 2014;202(1):W1-W12. <a href="https://doi.org/10.2214/ajr.12.10386">doi:10.2214/ajr.12.10386</a>
14. Schmidt M, Sung L, Shuckett B. Hemophagocytic Lymphohistiocytosis in Children: Abdominal US Findings Within 1 Week of Presentation. Radiology. 2004;230(3):685-9. <a href="https://doi.org/10.1148/radiol.2303030223">doi:10.1148/radiol.2303030223</a>
15. Colli A, Cocciolo M, Buccino G et al. Thickening of the Gallbladder Wall in Ascites. J Clin Ultrasound. 1991;19(6):357-9. <a href="https://doi.org/10.1002/jcu.1870190606">doi:10.1002/jcu.1870190606</a>
16. Zissin R, Osadchy A, Gayer G, Kitay-Cohen Y. Extrarenal Manifestations of Severe Acute Pyelonephritis: CT Findings in 21 Cases. Emerg Radiol. 2006;13(2):73-7. <a href="https://doi.org/10.1007/s10140-006-0503-y">doi:10.1007/s10140-006-0503-y</a>
Levy A, Murakata L, Rohrmann C. Gallbladder Carcinoma: Radiologic-Pathologic Correlation. Radiographics. 2001;21(2):295-314. <a href="https://doi.org/10.1148/radiographics.21.2.g01mr16295">doi:10.1148/radiographics.21.2.g01mr16295</a>

ADVERTISEMENT: Supporters see fewer/no ads