Sonography of the thickened gallbladder wall: a nonspecific finding

Shlaer, WJ; Leopold, George R.; Scheible, F. William

doi:10.2214/ajr.136.2.337

Cited by 131 publications

(50 citation statements)

References 14 publications

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“…Ultrasound is an operator-dependent imaging modality, that also needs to be considered as a possible failure in the initial examination of our case. Thickening of the gallbladder wall in patients with acute hepatitis, as in our case, has been reported previously [11][12][13] . As opposed to previous studies, we observed that there was also a correlation between these changes and the severity of liver necrosis and infl ammation.…”

Section: Discussionsupporting

confidence: 83%

Gallbladder Sludge and Acute Pancreatitis Induced by Acute Hepatitis A

2006

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Section: Discussionsupporting

confidence: 83%

Gallbladder Sludge and Acute Pancreatitis Induced by Acute Hepatitis A

2006

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“…Thickening of the gall bladder wall may be seen in cases of acute cholecystitis but alsoin casesof carcinomaof thegallbladder. Also,thickening of thegallblad der wall may be present in chronic cholecystitis, cirrhosis, hepatitis,pancreatitis,hypoalbumine mia, or congestive heart failure [6,7,21,22]. In our study, we found that congestive heart failure can cause thickening of the gallbladder wall, pericholecystic fluid, and striations, thus mim ickingacutecholecystitis on gray-scale sonog raphy.…”

Section: Discussionsupporting

confidence: 51%

“…In addition, sonographic Murphy's sign was en countered in seven patients who did not have acute cholecystitis. Finally, biliary stones may also be detected incidentally in asymptomatic individuals [6,8,21].…”

Section: Discussionmentioning

confidence: 99%

Color velocity imaging and power Doppler sonography of the gallbladder wall: a new look at sonographic diagnosis of acute cholecystitis.

Soyer¹,

Brouland²,

Boudiaf³

et al. 1998

American Journal of Roentgenology

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tamedin gray-scaleB-mode image scanlinesto determineblood flow velocity.We prospec tively determinedif color velocity imaging and power Doppler sonographycan be usedto differentiateacutefrom chroniccholecystitis. We analyzedthe potentialrole of usingthese two color imaging techniques as an adjunct to conventional gray-scale sonography to differen tiate acutefrom chroniccholecystitis. SUBJECTSAND METHODS. Onehundred twenty-nine patients withacuterightupperquadrant pain or clinically suspected cholecystitis underwent color velocity imaging and power Doppler sonography of the gallbladder as an adjunct to gray-scale sonography. Mor phologiccriteriawere analyzedon gray-scalesonography, andthepresenceof flow within the gallbladder wall was assessedwith color velocity imaging and power Doppler sonography. Imaging findingswere comparedwith pathologicfindingsin the 50 patientswho underwent cholecystectomy and with clinical and biologic findingsin the 79 patientswho did not un dergo cholecystectomy. RESULTS.Twenty-two patients hadsurgically provenacutecholecystitis, 28 patients hadsurgicallyprovenchroniccholecystitis, and79 patientshadnogallbladderdisease. Sensitivity, specificity,accuracy,positivepredictivevalue, and negativepredictivevalue of gray-scale sonography for revealing acute cholecystitis were 86%, 99%, 92%, 87%, and 97%, respec tively.Sensitivity, specificity, accuracy, positivepredictivevalue,andnegativepredictivevalue of color velocity imaging and power Doppler sonographyfor revealingacutecholecystitis were 95%, 100%, 99%, 100%, and 99%, respectively.

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“…congestive heart failure, and in patients after fatty food intake. 6 • 1 Segmental thickening of the gallbladder wall has been reported to occur in the hyperplastic cholecystoses, 11 gallbladder carcinoma, 0 • 10 and metastuses. 11 Further delineation of the character of a thick wall can be helpful in establishing a more specific diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Varices: a cause of focal gallbladder wall thickening.

Saigh¹,

Williams²,

Cawley³

et al. 1985

Journal of Ultrasound in Medicine

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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

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Sonography of the thickened gallbladder wall: a nonspecific finding

Cited by 131 publications

References 14 publications

Gallbladder Sludge and Acute Pancreatitis Induced by Acute Hepatitis A

Gallbladder Sludge and Acute Pancreatitis Induced by Acute Hepatitis A

Color velocity imaging and power Doppler sonography of the gallbladder wall: a new look at sonographic diagnosis of acute cholecystitis.

Varices: a cause of focal gallbladder wall thickening.

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