Although the sonographic finding of diffuse or focal thickening of the gallbladder wall is a common pathologic occurrence, the nonspecificity of the finding detracts from its usefulness. High-frequency, high· resolution ultrasound imaging and pulsed Doppler promise to allow more specific evaluation of the thick gallbladder wall in some cases. \Ve report a case in which high-resolution imaging and pulsed Doppler allowed differentiation of gallbladder varices from other causes of a thick-walled gallbladder.Sonographically detectable thickening of the gallbladder wall has been reported to occur in numerous intrinsic diseases of the gallbladder and in some systemic conditions. Although postulated, we are not aware of a report illustrating varices as a cause of a thick-walled gallbladder. Rosen and Wilson reported a case of gallbladder varices causing failure of sonographic delineation of the gallbladder and the a\1pearance of large vessels in the gallbladder fossa. We report a case in which enlarged vascular channels with characteristic venous flow were demonstrated by duplex sonography within a focally thickened gallbladder wall. REPORT OF A CASEA 43-year-old man presented with multiple painless subcutaneous nodules involving the lower extremities. His past medical history was significant for an episode of acute pancreatitis related to alcohol abuse one year prior to admission. Phvsical examination was unremarkable except for suhcutan.cous nodules over the lower extremities. Biopsy of the lesions showed chronic filt necrosis. At the time of admission, serum amylase was 2610 I U/L (normal : 0-115 IU/L) and lipase was greater than 90 units (normal:An ultrasound examination of th e upper abdomen showed multiple tubular channels in the porta hepatis without delineation of the portal vein, suggesting portal vein occlusion with collaterals. The gallbladder wall showed focal thickening. Because of this sonographic finding, an oral cholecystogram was performed that showed multiple smooth extrinsic indentations along the gallbladder wall ( fig. I). Computed tomography was performed after the
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.