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 Pain

  We conclude that poor emptying of the gallbladder may be associated with prolonged abdominal pain in Kawasaki syndrome. [ncbi.nlm.nih.gov]

• Vomiting

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

  Also added symptoms such as significant deterioration of health, vomiting, in which vomit is possible to detect the admixture of bile. This may indicate the development of this condition, like edema of the gallbladder. [hairmask3.org]

  Epigastric pain and discomfort in the right-upper-quadrant are common with frequent episodes of nausea and vomiting. [symptoma.com]

  Clinical features include abdominal pain, vomiting, fever and localised right upper quadrant tenderness over the gallbladder which may be palpable. Patients typically have a raised white cell count and inflammatory markers. [aibolita.com]

  Most common complication of gall stones and emergency cholecystectomy – Acute Acalculous CS (10-15% of cases) • Clinical features : – progressive right upper quadrant or epigastric pain – Mild fever – Anorexia – Tachycardia – Sweating – Nausea – Vomiting [slideshare.net]

• Epigastric Pain

  Epigastric pain and discomfort in the right-upper-quadrant are common with frequent episodes of nausea and vomiting. [symptoma.com]

  Pancreatitis Epigastric pain through to the back. Nausea and vomiting. Amylase/lipase levels should be elevated. 3. Peptic ulcer disease Epigastric pain radiating to the back. Pain relieved with eating but then recurs. [clinicaladvisor.com]

  Inflammatory cells may be present either in small numbers or in abundance. [1, 2, 4] Presentation Symptomatology of a gallbladder mucocele includes right upper quadrant (RUQ) pain or epigastric pain and discomfort, nausea, and vomiting. [thehealthscience.com]

  Signs and symptoms Symptoms of a gallbladder mucocele include the following: Right-upper-quadrant (RUQ) pain or epigastric pain and discomfort Nausea and vomiting The following suggest other conditions: Continuance of pain or persistence of tenderness [emedicine.medscape.com]

  View/Print Table TABLE 2 Differentiating Features of Gallstone-Induced Complications* Feature Biliary colic Acute cholecystitis Chronic cholecystitis Cholangitis Pancreatitis Pain site Epigastrium RUQ RUQ RUQ Epigastric Pain duration < 3 hours > 3 hours [aafp.org]

• 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]

• Heart Disease

  […] which are aggravated by the biliary colic and stones (diabetes, ischemic heart disease, chronic pancreatitis, chronic hepatitis). [bendomd.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]

• Hydrops Fetalis

  Stay at the forefront of your field thanks to new and completely revised chapters covering topics such as: Principles and Practice l Immune and Non-immune Hydrops Fetalis l Amniotic Fluid Volume l Enhancing Safe Prescribing in the Neonatal Intensive Care [books.google.com]

  Is there a period of time in which i am no longer in the danger zone of my baby getting hydrops fetalis or anemia. … read more Dr. [justanswer.com]

• Stroke

  Case of Ferumoxytol (Feraheme®) Prompting Critical Modification to Our Patient Prebreast Magnetic Resonance Imaging Questionnaire Naziya Samreen, Asha A Bhatt, James Glockner, Christine U Lee J Clin Imaging Sci 9 (6) 1-3 (28 March 2019) Case report: Stroke [clinicalimagingscience.org]

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]

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

Significant updates on bariatric surgery, Barrett's esophagus, endoscopic ultrasound, endosonography, treatment of liver disease, and much more keep you current on the latest advances. [books.google.com]

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]

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

[…] 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]

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]

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]

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]

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]

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]

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]

Prevention You can reduce your risk of cholecystitis by taking the following steps to prevent gallstones: Lose weight slowly. Rapid weight loss can increase the risk of gallstones. [mayoclinic.org]

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2. Feldman M, ed. Sleisenger and Fordtran's Gastrointestinal and Liver disease. 6th ed. Philadelphia, PA: WB Saunders Company; 1998.
3. Agrawal S, Jonnalagadda S. Gallstones, from gallbladder to gut. Management options for diverse complications. Postgrad Med. 2000;108(3):143-153.
4. Albu S, Voidazan S, Popa D. Gallbladder Hydrops Associated with an Episode of Acute Liver Toxicity in the Adult: May It Be Considered a Surgical Emergency or Not? Journal of Interdisciplinary Medicine. 2016;1(2):180-182.
5. Zong L, Chen P, Wang L, et al. A case of congenital giant gallbladder with massive hydrops mimicking celiac cyst. Oncol Lett. 2013;5(1): 226-228.
6. Rosen P, Barkin R. Emergency Medicine: Concepts and Clinical Practice. 4th ed. St. Louis, MO: Mosby-Year Book Inc; 1998.
7. Maurer K, Unsinn KM, Waltner-Romen M, et al. Segmental bowel-wall thickening on abdominal ultrasonography: an additional diagnostic sign in Kawasaki disease. Pediatr Radiol. 2008;38(9):1013-1016.
8. Mofti AB, Al-Momen A, Suleiman SI, et al. The single gallbladder stone - is it innocent?. Ann Saudi Med. 1994;14(6):471-473.
9. Vijayaraghavan R, Belagavi CS. Double gallbladder with different disease entities: a case report. J Min Access Surg. 2006;2:23-26.