- Shyam Varadarajulu, MD
Shyam Varadarajulu, MD
- Medical Director, Center for Interventional Endoscopy
- Professor of Medicine, University of Central Florida College of Medicine
- Salam F Zakko, MD, FACP
Salam F Zakko, MD, FACP
- Executive Director, Connecticut Gastroenterology Institute
- Clinical Professor of Medicine, University of Connecticut School of Medicine
- Section Editors
- Sanjiv Chopra, MD, MACP
Sanjiv Chopra, MD, MACP
- Editor-in-Chief — Gastroenterology/Hepatology
- Section Editor — General Hepatology; Gallbladder and Biliary Tract Disease
- Professor of Medicine
- Harvard Medical School
- Senior Consultant in Hepatology
- James Tullis Firm Chief
- Beth Israel Deaconess Medical Center
- Stanley W Ashley, MD
Stanley W Ashley, MD
- Section Editor — Pancreatic and Hepatobiliary Surgery
- Chief Medical Officer and Senior Vice President for Clinical Affairs
- Brigham and Women’s Hospital
- Frank Sawyer Professor of Surgery
- Harvard Medical School
Porcelain gallbladder is associated with chronic gallbladder inflammation. Approximately 95 percent of patients have associated gallstones. Patients with a porcelain gallbladder are often asymptomatic. The diagnosis is usually made incidentally on abdominal imaging. Porcelain gallbladder is associated with an increased risk for gallbladder cancer, but the magnitude of risk appears to be small. This topic will review the epidemiology, clinical presentation, diagnosis, and management of porcelain gallbladder. Gallbladder cancer, uncomplicated gallstone disease, acalculous cholecystitis, and acute cholecystitis are discussed separately. (See "Gallbladder cancer: Epidemiology, risk factors, clinical features, and diagnosis" and "Uncomplicated gallstone disease in adults" and "Choledocholithiasis: Clinical manifestations, diagnosis, and management" and "Acalculous cholecystitis".)
TERMINOLOGY AND SUBTYPES
Porcelain gallbladder is characterized by calcification of the gallbladder wall . The term porcelain gallbladder has been used to describe the bluish discoloration and brittle consistency of the gallbladder wall associated with this condition . Porcelain gallbladder is classified based upon the extent of calcification :
●Complete intramural calcification — A continuous band of calcium infiltrates and replaces the muscular layer of the gallbladder wall. It is accompanied by sloughing of the mucosal epithelium and dense fibrosis of the entire gallbladder wall.
●Selective mucosal calcification — Calcification of the gallbladder wall is less extensive or segmental with flecks of calcium in the mucosa of the gallbladder wall.
Incidence — Porcelain gallbladder is rare and is detected in 0.06 to 0.08 percent of cholecystectomy specimens . It has a female preponderance (5:1) and is usually diagnosed in the sixth decade of life .
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- TERMINOLOGY AND SUBTYPES
- Risk of malignancy
- CLINICAL PRESENTATION
- Clinical features
- Incidental imaging finding
- Diagnostic imaging
- - Computed tomography
- - Ultrasonography
- DIFFERENTIAL DIAGNOSIS
- Approach to management
- Conservative management
- SUMMARY AND RECOMMENDATIONS