Gallbladder hydrops refers to marked dilatation of the gallbladder due to chronic obstruction of the cystic duct resulting in accumulation of sterile non-pigmented mucin.
Abdominal pain with palpable gallbladder without any signs of infection. In an asymptomatic patient, it likely is related to fasting.
Chronic obstruction of the cystic duct results in accumulation of the sterile non-pigmented mucin in a distended gallbladder which sometimes can reach to the pelvis. Causes include:
- impacted stone
- tumours or polyps
- extrinsic compression by tumour, lymph node, or fibrosis
- Kawasaki disease
- parasites e.g. ascariasis
- >4 cm transverse measurement
- >9 cm longitudinal measurement
Treatment and prognosis
If seen on CT without an explanation, it is followed up with ultrasound if the patient has biliary colic symptoms.
- 1. Sebastian S, Araujo C, Neitlich JD et-al. Managing incidental findings on abdominal and pelvic CT and MRI, Part 4: white paper of the ACR Incidental Findings Committee II on gallbladder and biliary findings. J Am Coll Radiol. 2013;10 (12): 953-6. doi:10.1016/j.jacr.2013.05.022 - Pubmed citation
- 2. Brook OR, Kane RA, Tyagi G et-al. Lessons learned from quality assurance: errors in the diagnosis of acute cholecystitis on ultrasound and CT. AJR Am J Roentgenol. 2011;196 (3): 597-604. doi:10.2214/AJR.10.5170 - Pubmed citation
- 3. Queiroz AB, de Miranda JS. Images in clinical medicine. Hydropic gallbladder. N. Engl. J. Med. 2011;364 (20): e43. doi:10.1056/NEJMicm1000943 - Pubmed citation
- 4. Mathai SS, Kulkarni VB, Harsh P. Gall bladder hydrops - a rare initial presentation of Kawasaki disease. Indian J Pediatr. 2013;80 (7): 616-7. doi:10.1007/s12098-012-0890-x - Pubmed citation