Gangrenous cholecystitis
Gangrenous cholecystitis is the most common complication of acute cholecystitis, affecting ~15% (range 2-30%) of patients.
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Pathology
Gangrenous cholecystitis occurs as a result of ischaemia with necrosis of the gallbladder wall 4.
Risk factors
- male
- increasing age
- delayed surgery
- cardiovascular disease
- diabetes mellitus
Radiographic features
Ultrasound
In addition to features of acute cholecystitis, the following may help diagnose gangrenous cholecystitis 3:
- intraluminal membranes
- asymmetrical wall thickness
- focal perfusion defects on Doppler (representing areas of necrosis)
CT
In addition to features of acute cholecystitis, the following may help diagnose gangrenous cholecystitis 1:
- gallbladder wall or lumen gas
- focal irregularity or defect in the gallbladder wall
- intraluminal membranes
- absence of mural enhancement
- pericholecystic abscess
Treatment and prognosis
Mortality is increased compared to uncomplicated acute cholecystitis, estimated at between 15-50% 4.
Related articles
Ultrasound - gallbladder
- ultrasound (introduction)
- gallbladder ultrasound
- diffuse gallbladder wall thickening (differential)
- focal gallbladder wall thickening (differential)
- gallstones
- gallbladder sludge
- acute cholecystitis
- chronic cholecystitis
- gallbladder polyp
- adenomyomatosis
- porcelain gallbladder
- gallbladder carcinoma
- gallbladder metastases
- gallbladder lymphoma
- gallbladder volvulus / torsion
- variants and anomalies
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