Hydrops of the gallbladder can show a variety of symptoms. Epigastric pain and discomfort in the right-upper-quadrant are common with frequent episodes of nausea and vomiting. It often develops as a secondary condition masking a more serious ailment, for example, tumors in the bile duct, enlarged surrounding organs (e.g. hepatomegaly) or lymph nodes in the vicinity of the gallbladder. It can also form as a consequence of cholelithiasis. All these possible causes lead to a reduced capability of the bile duct to evacuate the gallbladder [1]. A hydrops of the gallbladder has also been reported after long periods of total parenteral nutrition and extended use of ceftriaxone. The condition presents as a large, palpable and somewhat tender mass in the epigastric region with minimal inflammatory signs. In extreme cases, the gallbladder can extend down to the pelvis [2].

If the above mentioned key symptoms are accompanied by fever, the bile is likely to be infected and suggests acute gallbladder empyema. If a patient exhibits jaundice, it is a strong indication of a common bile duct obstruction [3].

While hydrops of the gallbladder is quite common in children, in adults, it occurs concomitantly with acute toxic hepatitis [4]. Occasionally, an enlarged gallbladder could also be a congenital anomaly [5].

• Abdominal Mass

  The symptoms and signs of AHGB include abdominal pain, vomiting, abdominal mass and/or tenderness. [ncbi.nlm.nih.gov]

  Abdominal discomfort or pain on the upper right side (RUQ) or upper middle region (epigastric). Nausea and vomiting. Palpable abdominal mass with some tenderness Symptoms may worsen with eating, particularly fatty meals. [healthhype.com]

• Biliary Colic

  Treatment of biliary colic : aims to relieve pain, nausea, vomiting and anxiety. Bed rest is recommended during the painful phase. Medical treatment is addressed to uncomplicated biliary colic. [bendomd.com]

  The following features may help to distinguish an attack of biliary colic from acute cholecystitis. [sites.ualberta.ca]

  The accurate differentiation of gallstone-induced biliary colic from other abdominal disease processes is the most crucial step in the successful management of gallstone disease. [aafp.org]

  Dropsy of the bladder often begins with biliary colic (pain intense character in the right upper quadrant radiating to the right shoulder or scapula, often after intake of fatty and spicy foods or bumpy drive, calming after injection of morphine, pantopoda [lecheniebolezni.com]

• Gallbladder Enlargement

  […] duct 60 Courvoisier’s gallbladder gallbladder enlargement from obstruction at the level of the distal common bile duct. 61 Sonographic Appearance Courvoisier’s gallbladder Enlarged gallbladder Thin walls 62 causes Courvoisier’s gallbladder mass at the [easynotecards.com]

  Fig. 6. 18 Determining the dimensions of the gallbladder Enlargement of the gallbladder Large gallbladders can occur as morphologic variants ( Figs. 6.19, 6.20 ), especially in older patients and diabetics. [radiologykey.com]

• Liver Mass

  Clinical features • Liver mass • Non specific signs and symptoms : weight loss, pain, anorexia, ascites • If there is biliary obstruction : jaundice, acholic stool, nausea and vomiting, weight loss • Elevated alkaline phosphatase and aminotransferases [slideshare.net]

• Skin Lesion

  Henoch-Schönlein Syndrome (HSS) is characterized by the presence of purpuric skin lesions, colicky abdominal pain, renal manifestations, and arthritis. [ncbi.nlm.nih.gov]

There is no direct laboratory test to probe for a hydrops of the gallbladder. Consequently, it is necessary to utilize a plethora of imaging techniques in combination with laboratory studies to confirm the diagnosis.

Standard laboratory tests to consider are bilirubin levels and alkaline phosphatase levels, which can be mildly elevated as a consequence of an obstructed common bile duct. Serum amylase levels can be significantly raised as a consequence of acute pancreatitis, which may impair bile duct function. A mild leukocytosis is frequently observed in patients with a hydrops of the gallbladder [6].

An abdominal X-ray procedure typically reveals a hydrops of the gallbladder as a large globular shadow in the subhepatic region. This finding is nonspecific but should only be used as a backup check. An ultrasonographic image of the right upper quadrant can show a slightly thickened gallbladder wall and pinpoint the location of possible gallstones [7]. Computed tomography is well suited to check for possible hepatic or pancreatic conditions affecting the gallbladder. Both the extended gallbladder and the thickened wall are clearly visible, while it may be difficult to localize gallstones with this method [2].

Surgically opened hydropic gallbladders exhibit clear and watery or mucoid content, a white and slightly thickened wall and sometimes accumulated gallstones near the neck of the bile duct [8]. An extraordinarily thick gallbladder wall in combination with a viscous and opaque intraluminal fluid are indicative of gallbladder empyema or pyocele [9].

Review of diagnosis and treatment of 41 reported cases of hydrops of the gallbladder in Kawasaki syndrome from the English language literature is also presented. [ncbi.nlm.nih.gov]

If the positive dynamics of conservative treatment is missing, the patient performs the operation-cholecystectomy (removal of the gallbladder). At a dropsy gallbladder large size is always surgical treatment. [omedicine.info]

Surgery should be reserved for complicated cases only and rarely for those not responding to conservative treatment with worsening signs and symptoms. In such patients, cholecystectomy with or without drainage is the treatment of choice. [annsaudimed.net]

Treatment Treatment of this condition involves two areas – surgery or conservative treatment. Conservative therapy is carried out only if the edema. [hairmask3.org]

Causes include: impacted stone tumors or polyps extrinsic compression by tumor, lymph node, or fibrosis Kawasaki disease parasites e.g. ascariasis >4 cm transverse measurement >9 cm longitudinal measurement straight or convex borders Treatment and prognosis [radiopaedia.org]

[…] hydrops of the gallbladder (mucocele) chronic obstruction --> resorption of normal gallbladder contents and enlargement of the gallbladder by the production of large amounts of clear fluid (hydrops) or mucous secretions (mucocele) gallbladder cancer prognosis [quizlet.com]

Diagnosis confirmation: Surgery / Histo Which DD would be also possible with the radiological findings: Cholecystolithiasis Course / Prognosis / Frequency / Other : After pain management, laparoscopic choecystectomy. [kinderradiologie-online.de]

The prognosis is excellent if the diagnosis is correct and no complications have ensued. [emedicine.medscape.com]

[…] arise from cholangiocytes lining the intrahepatic and extrahepatic biliary ducts • Extrahepatic cholangiocarcinomas (2/3) of the tumours • Site : hilum (Klatskin tumour) or distal biliary tree • 50-70 years old • Asymptomatic until late stage • Poor prognosis [slideshare.net]

Kawasaki disease is an acute, febrile, systemic syndrome of unknown etiology which principally affects young children. [ncbi.nlm.nih.gov]

[…] answers 0 Etiology and pathogenesis HYDROPS OF THE GALLBLADDER (HYDROPS VESICAE FELLEAE) The blockage of the cystic duct by a stone or his scar narrowing to a complete obliteration of the lumen. [lecheniebolezni.com]

Hofmann (Halle/S) Email Address: Viewable for logged on visitors ( Log on ) Age: 14 Years Gender: Female Region-Organ: Abdomen-Other and unknown Most likely etiology: physical History: 14 year-old girl with trisomy 21. [kinderradiologie-online.de]

Core Learning Issues Definition of mucocele or hydrops of the gall bladder; Etiology of hydrops of the gallbladder; Pathophysiology and morphology; Symptomatology of hydrops of the gall bladder; Criteria considered when diagnosing hydrops of the gallbladder [pathology.jcu.edu.au]

It's divided into three sections on anatomy, pathophysiology, and epidemiology; diagnostic and therapeutic approaches including the latest therapeutic modalities; and specific conditions. Includes more than 250 illustrations for rapid reference. [books.google.com]

Rauch AM (1986) Kawasaki Syndrome: critical review of US epidemiology. In: Shulman ST (ed) Kawasaki disease. Proceedings of the Second International Kawasaki Disease Symposium. Alan R Liss Inc, New York, pp33–44 Google Scholar 9. [link.springer.com]

Kawasaki syndrome: critical review of US epidemiology. In: Shulman ST, editor. Kawasaki disease. Proceedings of the 2nd International Kawasaki Disease Symposium. New York: Alan R. Liss Inc, 1986:33-44. 5. Chamberlain JW, Hight DW. [annsaudimed.net]

Epidemiology Milk of Calcium gall bladder (AKA limy bile) is a rare finding (prevalence less than 1%) in patients that have undergone biliary lithiasis surgery. [proxraymanagement.com]

This was the cause of the mucocele in the gallbladder shown in the previous photograph Epidemiology Frequency About 3% of all pathologic gallbladders in adults are mucoceles. [thehealthscience.com]

It's divided into three sections on anatomy, pathophysiology, and epidemiology; diagnostic and therapeutic approaches including the latest therapeutic modalities; and specific conditions. Includes more than 250 illustrations for rapid reference. [books.google.com]

Core Learning Issues Definition of mucocele or hydrops of the gall bladder; Etiology of hydrops of the gallbladder; Pathophysiology and morphology; Symptomatology of hydrops of the gall bladder; Criteria considered when diagnosing hydrops of the gallbladder [pathology.jcu.edu.au]

Relevant Anatomy See Pathophysiology. Contraindications The contraindications to surgical treatment of mucocele of the gallbladder would obviously include any associated medical conditions or illnesses that preclude surgery. [thehealthscience.com]

Pathomorphology or Pathophysiology of this disease : N/A Radiological findings: Ultrasound 1: Widened gall bladder without emptying, thickening of the gall bladder wall with increased echogenicity. [kinderradiologie-online.de]

Pathogenesis The pathophysiological mechanism is unknown, however it is suggested to develop from stasis of bile content in the gallbladder such as a Phrygian cap or porcelain gallbladder, or due to bile duct (CBD) obstruction or pancreatic tumour. [proxraymanagement.com]

Clinical features of the disease and treatment regimens, including early administration of intravenous gamma globulin (IVGG), which prevents cardiac complications, are discussed. [ncbi.nlm.nih.gov]

Special attention is given to the prevention and treatment of these diseases found in developing countries as well as the latest findings about new antimicrobial agents, gram-negative infections and their management, and recommendations for immunization [books.google.com]

Prevention Is it possible to avoid the development of such a dangerous state prevention of the disease provided that certain conditions, which can generally be attributed to the list of rules for a healthy life: need periodic checkups; do not postpone [hairmask3.org]

Mucocoele develops when a gall-stone become impacted in Hartmann’s pouch, preventing bile from entering and leaving the gall bladder. [pathology.jcu.edu.au]

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