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Calcification of the Gallbladder

Gallbladder Calcification


Presentation

  • A 10-year-old girl is presented with PGB that was discovered incidentally during intravenous urography. Computed tomography localized the calcification to the gallbladder wall.[ncbi.nlm.nih.gov]
  • Potential pitfalls in the diagnosis of gallbladder calcification are presented, and the association between calcification and cancer is emphasized.[ncbi.nlm.nih.gov]
  • An extrahepatic bile duct obstruction was diagnosed in a 13-year-old boy presenting with pruritus, abdominal pain and jaundice.[ncbi.nlm.nih.gov]
  • This examination will demonstrate whether the gallbladder presented a neoplasm component or not. Porcelain Gallbladder 5 (99.05%) 42 votes[hellomrdoctor.com]
Asymptomatic
  • […] chronically inflamed and fibrotic muscular wall Wall is thickened and gallbladder is contracted Associated with gallstones in 90% Cystic duct is always obstructed 80% of patients with carcinoma of gallbladder have stones Clinical Findings Patients are usually asymptomatic[learningradiology.com]
  • She remained asymptomatic 15 months later.[drplace.com]
  • Five (33%) were asymptomatic and diagnosed incidentally. All specimens demonstrated chronic cholecystitis and partial calcification of the gallbladder wall. Nine (60%) had cholelithiasis.[ncbi.nlm.nih.gov]
  • Surgery should not be delayed even if the patient is asymptomatic since the occurence of carcinoma in porcelain gallbladder is remarkably high.[ncbi.nlm.nih.gov]
  • Often asymptomatic, Some present with biliary type pain. Rarely- firm, nontender mass in the RUQ Pathogenesis Gallbladder wall injury is due to chronic irritation by gallstones.[gastroenterologybook.com]
Chronic Infection
  • infection and compromised circulation from cystic duct obstruction, resulting in scarring, hyalinization and, finally, the deposition of lime salts. [6] The disease is five times more common in women between the ages of 38 and 84 years (with a mean age[drplace.com]
  • Risk Factors For Development Into Cancer Age 50 Diabetes mellitus Gallstones or biliary sludge Primary sclerosing cholangitis Chronic infection with Salmonella typhi Porcelain gallbladder (calcification of the gallbladder wall) Polyp that is single, greater[ehealthstar.com]
  • Typhoid People chronically infected with salmonella (the bacterium that causes typhoid) and those who are carriers of typhoid are more likely to get gallbladder cancer than those not infected.[cancer.org]
  • Other scientists have presented the calcification of the gallbladder as a dystrophic process, which occurs due to the chronic infection and compromised circulation.[hellomrdoctor.com]
Gangrene
  • […] pericholecystic 575.8 Atresia, atretic (congenital) 759.89 Atrophy, atrophic gallbladder 575.8 Calcification gallbladder 575.8 Cholangiectasis (see also Disease, gallbladder) 575.8 Cholangiohepatitis 575.8 Cholangiolitis (acute) (chronic) (extrahepatic) (gangrenous[icd9data.com]
  • Perforation of gallbladder K82.3 Fistula of gallbladder K82.4 Cholesterolosis of gallbladder K82.8 Other specified diseases of gallbladder K82.9 Disease of gallbladder, unspecified K82.A Disorders of gallbladder in diseases classified elsewhere K82.A1 Gangrene[icd10data.com]
  • A high white blood cell count may indicate a gangrenous or perforated gallbladder, or the presence of other pathology. 11, 13 Treatment Although the natural history of gallstones is generally benign, the physician must decide whether treatment is needed[aafp.org]
Swelling
  • These may include: Problems with anesthesia Infection Bleeding Swelling Bile leakage Damage to a bile duct Damage to your intestine, bowel, or blood vessels Deep vein thrombosis ( blood clots ) Heart problems Pneumonia You also run the risk of a problem[webmd.com]
  • Many of these are related in some way to chronic inflammation (long-lasting irritation and swelling) in the gallbladder. Gallstones Gallstones are the most common risk factor for gallbladder cancer.[cancer.org]
Acute Abdomen
  • abdomen and new material on CT and MR angiography, lung cancer screening, pulmonary embolism, coronary artery calcium screening, and interventional CT techniques including radiofrequency ablation and CT fluoroscopy.[books.google.com]
  • However, CT has become popular for evaluating the acute abdomen and often is the first modality to detect gallbladder wall thickening [2], or it may be used as an adjunct to an inconclusive sonography or for staging of disease.[radiologyassistant.nl]
Fat Intolerance
  • intolerance 1.3 0.83 43 68 Tenderness of upper abdomen 1.3 0.73 62 53 Food intolerance 1.2 0.86 51 57 Upper abdominal pain 1.2 0.74 68 43 Acute cholecystitis Murphy sign* (general population) 5.0 0.4 65 87 Chills 2.6 0.9 13 95 Right upper quadrant pain[aafp.org]
Chest Pain
  • Dear DR I've suffered abdominal pain for about a year, had my gallbladder removed a year a go, have gastritis, and 4-5monts ago my I suffered chest pain, upper a … read more RK Gastroenterologist/Pediatrician Doctoral Degree 548 satisfied customers I[justanswer.com]
  • Chest pain. Although pain related to a gallbladder problem is most typically reported in the abdomen, substernal (chest) pain, as well as right shoulder pain, may be related to the gallbladder. Nausea.[everydayhealth.com]
  • Her history was negative for nausea, fever, vomiting, chest pain, heartburn, back pain, or changes in bowel movement patterns. There was no association between the pain and her eating patterns.[mdedge.com]
Hypertension
  • Illustrative Case A 61-year-old woman with hypertension and diabetes presented with an eightmonth history of pain in the right upper quadrant. She had a long history of intermittent intolerance to fatty foods.[drplace.com]
  • These patients also present significant surgical challenges with risk of liver failure and significant bleeding in the face of portal hypertension.[aafp.org]
Pruritus
  • An extrahepatic bile duct obstruction was diagnosed in a 13-year-old boy presenting with pruritus, abdominal pain and jaundice.[ncbi.nlm.nih.gov]
  • Mechanical bile drainage can often relieve pruritus, recurrent sepsis, and pain due to biliary obstruction. Cholangiocarcinomas and other bile duct tumors are rare (1 to 2/100,000 people) but are usually malignant.[merckmanuals.com]
  • She denied emesis, jaundice, icterus, pruritus, or symptoms of altered mental status. Physical examination was unremarkable. Laboratory studies showed only borderline elevated total bilirubin.[bmcresnotes.biomedcentral.com]
Back Pain
  • Her history was negative for nausea, fever, vomiting, chest pain, heartburn, back pain, or changes in bowel movement patterns. There was no association between the pain and her eating patterns.[mdedge.com]
Suggestibility
  • This observation suggests that the plain radiograph is no longer adequate for evaluating possible calcifications in the upper abdomen.[ncbi.nlm.nih.gov]
  • Hence our results suggested that measurement of the CT number of stones is useful to evaluate the calcium content of gallstones, and that the gallbladder contractility could be one of the factors to influence calcification of stones.[ncbi.nlm.nih.gov]
  • Diagnosis is suggested on the plain abdominal roentgenogram by identifying thin curvilinear calcifications in the right upper quadrant.[ncbi.nlm.nih.gov]
  • Ten patients (67%) had symptoms suggestive of biliary colic or cholecystitis. Five (33%) were asymptomatic and diagnosed incidentally. All specimens demonstrated chronic cholecystitis and partial calcification of the gallbladder wall.[ncbi.nlm.nih.gov]
  • However, recent reviews suggest that the association between porcelain gallbladder and cancer is less than previously suggested.[cmaj.ca]
Irritability
  • […] calcification is unknown, but it occurs as either a broad, continuous band in the muscularis or as multiple, punctate areas in both the glandular spaces and the Rokitansky-Aschoff sinuses. [3] The mechanism of injury appears to be related to chronic irritation[drplace.com]
  • It is believed that it caused by irritation the gallbladder by stones which lead to chronic inflammation associated with calcium deposit (2).[czytelniamedyczna.pl]
  • Rarely- firm, nontender mass in the RUQ Pathogenesis Gallbladder wall injury is due to chronic irritation by gallstones.[gastroenterologybook.com]
  • The constant irritation seems to lead to a process of chronic inflammation, with calcium deposits appearing at the level of the gallbladder wall.[hellomrdoctor.com]
Bladder Pain
  • Arun Phophalia Doctor (MD) Post-Doctoral Degree 19,897 satisfied customers I have liver cyst calcified densities(ovarian cyst ) in both I have liver cyst calcified densities(ovarian cyst ) in both ovaries, sharp bladder pain, lower left back and side[justanswer.com]

Workup

  • Diagnosis is made in most cases by a simple flat plate of the abdomen, and workup should include other roentgenographic examinations to exclude calcification of other viscera or the thoracic wall.[ncbi.nlm.nih.gov]
  • In our patient, after his cholecystectomy a hematologic workup was recommended to his primary physician. Laparoscopic cholecystectomy can be safely performed in the case of symptomatic cholelithiasis in this population.[bmcresnotes.biomedcentral.com]
  • A cholecystokinin-HIDA scan is helpful in patients with suspected gallstones, but who have normal findings on ultrasonography and workup for their symptoms (e.g., upper endoscopy, upper gastrointestinal series, negative Helicobacter pylori serology).[aafp.org]

Treatment

  • Treatment consists of cholecystectomy with a careful search for malignancy.[ncbi.nlm.nih.gov]
  • Single-incision laparoscopic cholecystectomy was feasible and safe for the treatment of porcelain gallbladder in our patient.[jstage.jst.go.jp]
  • […] irregular clumps of echoes with posterior acoustic shadowing Differential Diagnosis Imaging pitfall Contracted gallbladder with calcified wall can be mistaken for a gallstone Calcified hydatid cyst of liver Large gallstone with peripheral calcification Treatment[learningradiology.com]
  • The unique character of this disease and the treatment implications of the diagnosis comprise the basis of this report.[drplace.com]
  • Neither a case of porcelain gallbladder with extrahepatic bile duct obstruction in a child nor a successful treatment of the obstruction by long-term stenting has been described in the literature yet.[ncbi.nlm.nih.gov]

Prognosis

  • […] gallbladder with calcified wall can be mistaken for a gallstone Calcified hydatid cyst of liver Large gallstone with peripheral calcification Treatment Because of its high association with carcinoma of the gallbladder, a cholecystectomy is usually performed Prognosis[learningradiology.com]
  • Cholecystitis --Typically in a woman in her 40s Gallbladder carcinoma --In an elderly woman (too old for cholecystitis) Gallbladder Carcinoma: What is the prognosis for gallbladder carcinoma? Poor prognosis --Typically has already invaded[quizlet.com]
  • Treatment and prognosis Based on early studies which revealed a high association between porcelain gallbladder and gallbladder adenocarcinoma (22-30% of porcelain gallbladders developing gallbladder adenocarcinoma 3 ), cholecystectomy has been routinely[radiopaedia.org]
  • Gallbladder Cancer Risk Porcelain gallbladders were once thought to have a high risk of developing gallbladder cancer, a condition that has a poor prognosis, but the relationship is actually much less clear.[livehealthy.chron.com]
  • […] was associated with cancer). 3 Similarly, a review of about 25 900 cholecystectomy records identified 150 cases of gallbladder cancer and 44 of calcified gallbladder, with about 7% of the calcified specimens showing signs of cancer. 6 Given the poor prognosis[cmaj.ca]

Etiology

  • The etiology, diagnosis, and management of PGB and its significance in a pediatric patient are discussed.[ncbi.nlm.nih.gov]
  • GI Radiology Biliary Gallbladder Neoplastic Porcelain Gallbladder Neoplastic Diseases of Gallbladder Pathogenesis: Unknown etiology, most likely due to chronic gallbladder inflammation and gallstones. Women are most frequently affected.[med-ed.virginia.edu]
  • Best Answer: Hi Tiki Porcelain or calcified gallbladder is a relatively rare condition and not much is known about its etiology. Whether it is associated with gallbladder cancer or not appears to still be up for debate.[answers.yahoo.com]
  • Regardless of etiology, these patients usually will present with postprandial abdominal pain, and ultrasonography is the mainstay of diagnosis. However, some gallstones are radiopaque and can be visualized on plain abdominal radiography.[bmcresnotes.biomedcentral.com]

Epidemiology

  • Written by Dr Sebastian Zeki Histopathology: Epidemiology The incidence is 0.1%. M:F 1:5. Mean age is 50. 15% get gallbladder cancer.[gastroenterologybook.com]
  • PubMed View Article Google Scholar Stinton LM, Myers RP, Shafer EA: Epidemiology of gallstones. Gastroenterol Clin N Am. 2010, 39: 157-169. 10.1016/j.gtc.2010.02.003.[bmcresnotes.biomedcentral.com]
  • Over the past two decades, much has been learned about the epidemiology of this condition and its risk factors 2 ( Table 1 3 ).[aafp.org]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology: Histologically, flakes of dystrophic calcium exist within the chronically inflamed gallbladder wall. The muscular wall of the gallbladder undergoes fibrotic changes.[curezone.org]
  • The exact pathophysiologic mechanism leading to oedema of the gallbladder wall in these diverse conditions is uncertain, but it is likely due to elevated portal venous pressure, elevated systemic venous pressure, decreased intravascular osmotic pressure[radiologyassistant.nl]

Prevention

  • Diet There is no specific diet that would prevent gallbladder polyps. Since gallbladder polyps are commonly associated with gallstones, the diet that can help prevent gallstones may also reduce the risk of gallbladder polyps [3,4].[ehealthstar.com]
  • The first one moves calcium around the body, MGP prevents calcium from going into arteries, ducts and all kinds of soft tissues, and GAS6 is effective for cancer protection.[gallbladderattack.com]
  • Certain chemicals in tea may prevent cells from growing abnormally and may have anti-inflammatory effects that reduce the risk of these bile tract diseases. International Journal of Cancer, 2006.[raysahelian.com]
  • But dietary changes don’t always help prevent gallbladder attacks. If surgery isn’t an option for you, your doctor can prescribe a medication to dissolve your gallstones. But this can take months or even years to work.[webmd.com]

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