US findings of xanthogranulomatous cholecystitis

Kim, P.N.; Ha, Hyun Kwon; Kim, Y.H.; Lee, M.-G.; Kim, M.H.; Auh, Yong Ho

doi:10.1016/s0009-9260(98)80129-3

Cited by 49 publications

(29 citation statements)

References 11 publications

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“…Three groups of researchers have reported a hypo-echoic nodule or band (sonolucent halo) in the gallbladder wall, to be the most characteristic finding in the disease. [9][10][11] Occasionally, a complex, poorly defined mass mimicking malignancy is visualised on ultrasonography. 12 Ultrasonography can also detect complications like gallbladder perforation with abscess formation and gas in the biliary tree due to fistula.…”

Section: Features Numbermentioning

confidence: 99%

Perfidious Gallbladders – A Diagnostic Dilemma with Xanthogranulomatous Cholecystitis

Srinivas

Sinha

Ryley

et al. 2007

annals

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INTRODUCTION Xanthogranulomatous cholecystitis (XGC) is an uncommon variant of chronic cholecystitis characterised by marked thickening of the gallbladder wall and dense local adhesions. Pre-operative and intra-operative diagnosis is difficult and it often mimics a gallbladder carcinoma (GBC). Laparoscopic cholecystectomy (LC) is frequently unsuccessful with a high conversion rate. A series of patients with this condition led us to review our experience with XGC and to try to develop a care pathway for its management. PATIENTS AND METHODS A retrospective review of the medical records of 1296 consecutive patients who had undergone cholecystectomy between January 2000 and April 2005 at our hospital was performed. Twenty-nine cases of XGC were identified among these cholecystectomies. The clinical, radiological and operative details of these patients have been analysed. RESULTS The incidence of XGC was 2.2% in our study. The mean age at presentation was 60.3 years with a female:male ratio of 1.4:1. Twenty-three patients (79%) required an emergency surgical admission at first presentation. In three patients, a GBC was suspected both radiologically and at operation (10.3%), but was later disproved on histology. Seventeen patients (59%) had obstructive jaundice at first presentation and required an endoscopic retrograde cholangiopancreatography (ERCP) before LC. Of these, five had common bile duct stones. Abdominal ultrasound scan showed marked thickening of the gallbladder wall in 16 cases (55%). LC was attempted in 24 patients, but required conversion to an open procedure in 11 patients (46% conversion rate). A total cholecystectomy was possible in 18 patients and a partial cholecystectomy was the choice in 11 (38%). The average operative time was 96 min. Three patients developed a postoperative bile leak, one of whom required ERCP and placement of a biliary stent. The average length of stay in the hospital was 6.3 days. CONCLUSIONS Severe xanthogranulomatous cholecystitis often mimics a gallbladder carcinoma. Currently, a correct pre-operative diagnosis is rarely made. With increased awareness and a high index of suspicion, radiological diagnosis is possible. Preoperative counselling of these patients should include possible intra-operative difficulties and the differential diagnosis of gallbladder cancer. Laparoscopic cholecystectomy is frequently unsuccessful and a partial cholecystectomy is often the procedure of choice.

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Section: Features Numbermentioning

confidence: 99%

Perfidious Gallbladders – A Diagnostic Dilemma with Xanthogranulomatous Cholecystitis

Srinivas

Sinha

Ryley

et al. 2007

annals

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“…9 In this case report, the patient had the symptoms in the right hypochondrial region and suffered from radiating pain in the shoulder and back, nausea, vomiting, and fever. Yet, some features on US 4 and CT 10 were highly suggestive of XGC, including thickening of the GB wall, GB stone shadow, and adhesion to neighboring tissues and organs. Despite all these distinctions, it is difficult to differentiate XGC from carcinoma of the GB clinically.…”

Section: Discussionmentioning

confidence: 99%

“…1 Although well-defined pathologically, XGC still remains difficult for the radiologist to recognize because some of the sonographic and computed tomography (CT) [2][3][4] features of the disease are nonspecific, such as GB wall thickening and calculi. This case report describes the clinical, sonographic, and CT findings in one patient with histologically diagnosed XGC.…”

Section: Introductionmentioning

confidence: 99%

Xanthogranulomatous Cholecystitis

Alhomoud¹,

Abdel‐Mohsen²

2017

WJOLS

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Xanthogranulomatous cholecystitis is a rare, benign, chronic inflammatory disease of the gallbladder (GB). Its importance lies in the fact that imaging studies and intraoperative appearance may mimic tumor of the GB. Xanthogranulomatous cholecystitis is difficult to diagnose pre-or intraoperatively and remains a challenge in medical practice. The definitive diagnosis depends on the histopathologic examination.

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“…Xanthogranulomatous cholecystitis is an uncommon form of chronic cholecystitis, representing between 0.7% and 13.2% of gallbladder disease1 2 and mainly affecting women between 60 and 70 years old 1 3 4. Its importance lies in the fact that clinically and radiologically it can be confused with the carcinoma of the gallbladder 2 5…”

Section: Discussionmentioning

confidence: 99%