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Porcelain gallbladder

Authors
Shyam Varadarajulu, MD
Salam F Zakko, MD, FACP
Section Editors
Sanjiv Chopra, MD, MACP
Stanley W Ashley, MD
Deputy Editor
Shilpa Grover, MD, MPH, AGAF

INTRODUCTION

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 [1]. The term porcelain gallbladder has been used to describe the bluish discoloration and brittle consistency of the gallbladder wall associated with this condition [2]. Porcelain gallbladder is classified based upon the extent of calcification [3]:

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.

EPIDEMIOLOGY

Incidence — Porcelain gallbladder is rare and is detected in 0.06 to 0.08 percent of cholecystectomy specimens [4]. It has a female preponderance (5:1) and is usually diagnosed in the sixth decade of life [5].

                

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Literature review current through: Mar 2017. | This topic last updated: Apr 19, 2017.
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References
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