Porcelain gallbladder
Updates to Article Attributes
A porcelain gallbladder refers to extensive calcium encrustation of the gallbladder wall. The term porcelain gallbladder has been used to emphasize the blue discoloration and brittle consistency of the gallbladder wall at surgery.
Clinical presentation
Patients are usually asymptomatic, and porcelain gallbladder is found incidentally on plain abdominal radiographs, sonograms, or CT images.
Associations
- chronic cholecystitis
Radiographic features
Plain film and CT
The appearance on both CT and plain film are pathognomonic, demonstrating a thin layer of mineralisation outlining the gallbladder wall.
Ultrasound
On ultrasound, the gallbladder demonstrates dense shadowing, which can be mistaken for gas in the wall (emphysematous cholecystitis) or lumen of the gallbladder, or one or more gallstones.
Treatment and prognosis
Based on early studies which revealed a high association between porcelain gallbladder and gallbladder adenocarcinoma (22 - 30 % of porcelain gallbladders will develop gallbladder adenocarcinoma 3), cholecystectomy has been routinely performed when a porcelain gallbladder is identified. More recent studies have case some doubt on the association 1.
Differential diagnosis
General imaging differential considerations include
On ultrasound - also consider
- gas : shadowing of air tends to be dirty, rather than the clean anechoic shadow of calcification
-<p>A<strong> porcelain gallbladder</strong> refers to extensive calcium encrustation of the gallbladder wall. The term porcelain gallbladder has been used to emphasize the blue discoloration and brittle consistency of the gallbladder wall at surgery.</p><h4>Clinical presentation</h4><p>Patients are usually asymptomatic, and porcelain gallbladder is found incidentally on plain abdominal radiographs, sonograms, or CT images.</p><h4>Radiographic features</h4><h5>Plain film and CT</h5><p>The appearance on both CT and plain film are pathognomonic, demonstrating a thin layer of mineralisation outlining the gallbladder wall. </p><h5>Ultrasound</h5><p>On ultrasound, the gallbladder demonstrates dense shadowing, which can be mistaken for gas in the wall (emphysematous cholecystitis) or lumen of the gallbladder, or one or more gallstones. </p><h4>Treatment and prognosis</h4><p>Based on early studies which revealed a high association between porcelain gallbladder and <a title="Gallbladder adenocarcinoma" href="/articles/gallbladder-adenocarcinoma">gallbladder adenocarcinoma</a> (22 - 30 % of porcelain gallbladders will develop gallbladder adenocarcinoma <sup>3</sup>), cholecystectomy has been routinely performed when a porcelain gallbladder is identified. More recent studies have case some doubt on the association <sup>1</sup>. </p><h4>Differential diagnosis</h4><p>General imaging differential considerations include</p><ul>-<li><a title="cholelithiasis" href="/articles/cholelithiasis">cholelithiasis</a></li>-<li><a title="limy bile" href="/articles/limy-bile">limy bile</a></li>-</ul><p>On ultrasound - also consider</p><ul><li>gas : shadowing of air tends to be dirty, rather than the clean anechoic shadow of calcification-<ul>-<li><a title="Emphysematous cholecystitis" href="/articles/emphysematous-cholecystitis">emphysematous cholecystitis</a></li>-<li><a title="Pneumobilia" href="/articles/pneumobilia">pneumobilia </a></li>- +<p>A<strong> porcelain gallbladder</strong> refers to extensive calcium encrustation of the gallbladder wall. The term porcelain gallbladder has been used to emphasize the blue discoloration and brittle consistency of the gallbladder wall at surgery.</p><h4>Clinical presentation</h4><p>Patients are usually asymptomatic, and porcelain gallbladder is found incidentally on plain abdominal radiographs, sonograms, or CT images.</p><h4>Associations</h4><ul><li>chronic cholecystitis</li></ul><h4>Radiographic features</h4><h5>Plain film and CT</h5><p>The appearance on both CT and plain film are pathognomonic, demonstrating a thin layer of mineralisation outlining the gallbladder wall. </p><h5>Ultrasound</h5><p>On ultrasound, the gallbladder demonstrates dense shadowing, which can be mistaken for gas in the wall (emphysematous cholecystitis) or lumen of the gallbladder, or one or more gallstones. </p><h4>Treatment and prognosis</h4><p>Based on early studies which revealed a high association between porcelain gallbladder and <a href="/articles/gallbladder-adenocarcinoma">gallbladder adenocarcinoma</a> (22 - 30 % of porcelain gallbladders will develop gallbladder adenocarcinoma <sup>3</sup>), cholecystectomy has been routinely performed when a porcelain gallbladder is identified. More recent studies have case some doubt on the association <sup>1</sup>. </p><h4>Differential diagnosis</h4><p>General imaging differential considerations include</p><ul>
- +<li><a href="/articles/cholelithiasis">cholelithiasis</a></li>
- +<li><a href="/articles/limy-bile">limy bile</a></li>
- +</ul><p>On ultrasound - also consider</p><ul><li>gas : shadowing of air tends to be dirty, rather than the clean anechoic shadow of calcification<ul>
- +<li><a href="/articles/emphysematous-cholecystitis">emphysematous cholecystitis</a></li>
- +<li><a href="/articles/pneumobilia">pneumobilia </a></li>
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