gallbladder hydrops

Gallenblasenhydrops
mit Zeichen der Cholecystitis bei impaktiertem Infundibulumkonkrement bei einer 95-jährigen Patientin. Ein weiteres, verkalktes Konkrement findet sich im Fundus der Gallenblase. Aufgrund des schlechten Allgemeinzustandes der Patientin primäre Therapie mit transhepatischer Gallenblasendrainage (8,3 F). Der transhepatische Weg wird gewählt um eine freie Leckage nach peritoneal zu vermeiden.
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Preschooler
with right upper quadrant pain and jaundice. The diagnosis was Kawasaki’s disease causing hydrops of the gallbladder.
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Gallbladder
hydrops caused by scarlet fever. Ultrasound shows a distended gallbladder
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Toddler who
had a renal transplant 3 days ago and who now has abdominal distension. Transverse (above) and sagittal (below) US of the liver shows an extremely dilated gallbladder that is filled with anechoic fluid. Ascites is also present inferior to the liver on the sagittal image.The diagnosis was gallbladder hydrops.
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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.

Siehe auch:
Assoziationen und Differentialdiagnosen zu Gallenblasenhydrops:
Gallenblasendrainage
 
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