Fact-sheet: Porcelain gallbladder
Updated on 04/23/2019 at 9:55 AM
View all RADEOS cases associated with this fact-sheet
Definition
Chronic calcium incrustation of the gallbladder wall.
Pathophysiology poorly defined, but the mechanism appears similar to gallstone formation.
Potentially related to chronic gallbladder disease. Prevalence: rare, less than 1% of cholecystectomies.
Female predominance: 5 to 1.
Risk factors: age, presence of gallstones (95% of cases, presence of stones and the etiologies leading to stone formation).
Clinical features
Asymptomatic or associated with symptoms of gallbladder lithiasis.
Some patients present with signs of chronic cholecystitis.
Laboratory findings
unremarkable
Radiography
Gallbladder with calcified walls on plain abdominal radiograph.
Ultrasound
Ultrasound beam blocked by wall calcifications, with posterior acoustic shadowing.
Misleading appearance, which may raise the differential diagnosis of gallbladder wall emphysema.
CT
Reference examination.
Partial or diffuse calcification of the gallbladder wall, without pathological wall thickening.
+/- gallstones visible on CT.
Rule out gallbladder carcinoma: no soft tissue nodule / no extension into the adjacent liver / no extension into the cystic duct.
MRI
Calcified wall = hyposignal.
Nuclear medicine
no
Management
Several older studies showed a correlation between porcelain gallbladder and gallbladder cancer (hence the historical indication for cholecystectomy).
Several recent studies refute this finding.
Trend toward conservative management (surveillance?).
Differential diagnosis
Gallbladder carcinoma.