Porcelain gallbladder
Encyclopedia
Porcelain gallbladder is a calcification
of the gallbladder
believed to be brought on by excessive gallstone
s, although the exact cause
is not clear. As with gallstone disease in general, this condition occurs predominantly in overweight female patients of middle age. It is a morphological variant of chronic cholecystitis. Inflammatory scarring of the wall, combined with dystrophic calcification within the wall transforms the gallbladder into a porcelain-like vessel.
, but the precise nature of the association is uncertain. Two review articles examined the association between cancer of the gallbladder and calcified gallbladder. One study reported an incidence of gallbladder cancer of about 1% in patients with calcified gallbladder. Another study found that of 69 calcified gallbladders, 3 of them contained cancer.
(especially after eating), jaundice
, and vomiting
. First symptom to appear is Jaundice followed by Right upper quadrant pain.
(X-ray), abdominal ultrasound
or CT scan.
, although laparoscopic cholecystectomy is contraindicated in this case because of fear of seeding of cancer cells in the trochar sites.
Calcification
Calcification is the process in which calcium salts build up in soft tissue, causing it to harden. Calcifications may be classified on whether there is mineral balance or not, and the location of the calcification.-Causes:...
of the gallbladder
Gallbladder
In vertebrates the gallbladder is a small organ that aids mainly in fat digestion and concentrates bile produced by the liver. In humans the loss of the gallbladder is usually easily tolerated....
believed to be brought on by excessive gallstone
Gallstone
A gallstone is a crystalline concretion formed within the gallbladder by accretion of bile components. These calculi are formed in the gallbladder, but may pass distally into other parts of the biliary tract such as the cystic duct, common bile duct, pancreatic duct, or the ampulla of...
s, although the exact cause
Etiology
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....
is not clear. As with gallstone disease in general, this condition occurs predominantly in overweight female patients of middle age. It is a morphological variant of chronic cholecystitis. Inflammatory scarring of the wall, combined with dystrophic calcification within the wall transforms the gallbladder into a porcelain-like vessel.
Association with cancer
Porcelain gallbladder is associated with gallbladder cancerGallbladder cancer
Gallbladder cancer is a relatively uncommon cancer. It has peculiar geographical distribution being common in central and South America, central and eastern Europe, Japan and northern India; it is also common in certain ethnic groups e.g. Native American Indians and Hispanics. If it is diagnosed...
, but the precise nature of the association is uncertain. Two review articles examined the association between cancer of the gallbladder and calcified gallbladder. One study reported an incidence of gallbladder cancer of about 1% in patients with calcified gallbladder. Another study found that of 69 calcified gallbladders, 3 of them contained cancer.
Symptoms
Symptoms can include abdominal painAbdominal pain
Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. Making a definitive diagnosis of the cause of abdominal pain can be difficult, because many diseases can result in this symptom. Abdominal pain is a common problem...
(especially after eating), jaundice
Jaundice
Jaundice is a yellowish pigmentation of the skin, the conjunctival membranes over the sclerae , and other mucous membranes caused by hyperbilirubinemia . This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluid...
, and vomiting
Vomiting
Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose...
. First symptom to appear is Jaundice followed by Right upper quadrant pain.
Diagnosis
Abdominal radiographyRadiography
Radiography is the use of X-rays to view a non-uniformly composed material such as the human body. By using the physical properties of the ray an image can be developed which displays areas of different density and composition....
(X-ray), abdominal ultrasound
Ultrasound
Ultrasound is cyclic sound pressure with a frequency greater than the upper limit of human hearing. Ultrasound is thus not separated from "normal" sound based on differences in physical properties, only the fact that humans cannot hear it. Although this limit varies from person to person, it is...
or CT scan.
Treatment
Recommended treatment is surgical removal of the gallbladderCholecystectomy
Cholecystectomy is the surgical removal of the gallbladder. It is the most common method for treating symptomatic gallstones. Surgical options include the standard procedure, called laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy.-Open surgery:A...
, although laparoscopic cholecystectomy is contraindicated in this case because of fear of seeding of cancer cells in the trochar sites.
External links
- eMedicine.com — Porcelain Gallbladder by Ali Nawaz Khan and Margaret Aird