gallbladder hydrops

Gallbladder hydrops or mucocele  refers to marked dilatation of the gallbladder due to chronic obstruction of the cystic duct resulting in accumulation of sterile non-pigmented mucin.

Clinical presentation

Abdominal pain with palpable gallbladder without any signs of infection. In an asymptomatic patient, it likely is related to fasting.

Pathology

Chronic obstruction of the cystic duct results in accumulation of the sterile non-pigmented mucin in a distended gallbladder which sometimes can reach the pelvis. Causes include:

  • impacted stone
  • tumors or polyps 
  • extrinsic compression by tumor, lymph node, or fibrosis
  • Kawasaki disease
  • parasites e.g. ascariasis

Radiographic features

  • >4 cm transverse measurement
  • >9 cm longitudinal measurement
  • straight or convex borders

Treatment and prognosis

If seen on CT without an explanation, it is followed up with ultrasound if the patient has biliary colic symptoms.

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