Demographics:
77 years old, Female
Indication:
Right upper quadrant pain, negative sonographic Murphy ...
Right upper quadrant pain, negative sonographic Murphy sign
Findings
- Thickened, echogenic gallbladder wall with extensive corresponding posterior acoustic shadowing, which obscures much of the gallbladder
- The visualized pericholecystic spaces show no definite fluid or inflammatory changes
- Normal appearance of the liver and right kidney
- Antegrade flow in the main portal vein
- No biliary duct dilation
- The visualized portion of the pancreas appears normal
- The visualized portions of the abdominal aorta are normal in caliber
Diagnosis
Porcelain gallbladder
Sample Report
Extensive mural calcification of the gallbladder ("porcelain gallbladder"), which is associated with an increased (but still low) risk for gallbladder adenocarcinoma. Although there are no specific findings for acute cholecystitis, the gallbladder is difficult to assess on this study and surgery consultation should be pursued if there are ongoing symptoms. If cholecystectomy is not performed, then followup surveillance imaging with contrast-enhanced CT or MRI is recommended in 6-12 months.
No additional findings to explain right upper quadrant pain.
Discussion