Possible causes of gallbladder wall thickening

Possible causes of gallbladder wall thickening

Normally, the gallbladder wall measures 3 mm or less in thickness.

What are the Possible causes of gallbladder wall thickening?

There are multiple etiologies for gallbladder wall thickening. Some of them are mentioned below.

  • generalized edematous states (congestive heart failure, renal failure, hypoalbuminemia, cirrhosis)
  • gallbladder inflammation (cholecystitis or secondary inflammation from acute hepatitis)
  • neoplasm (gallbladder adenocarcinoma, metastasis)
  • adenomyomatosis 
  • Thickening of the gallbladder wall is a relatively frequent finding at diagnostic imaging studies.

Gallbladder wall thickening, associated with features like perforation, fistula formation and invasion of adjacent organs, is often assumed to be malignant.

Thickening of the gallbladder wall is a relatively frequent finding on diagnostic imaging. Such thickening is also a common but nonspecific finding in many patients with intrinsic gallbladder disease and extracholecystic conditions.

  • Historically, a thick-walled gallbladder has been regarded as proof of primary gallbladder disease, and it is a well-known hallmark feature of acute cholecystitis.
  • The finding itself, however, is non-specific and can be found in a wide range of gallbladder diseases and extracholecystic pathological conditions.

This is of clinical importance. Misinterpretation of the cause of thickening can trigger unnecessary cholecystectomies in patients without intrinsic gallbladder disease.

Also, misdiagnosis of patients who do in fact require cholecystectomy may delay treatment, thus increasing morbidity.

Wall thickening may be diagnostically problematic, occurring (as it does) in both symptomatic and asymptomatic patients and in those with and without indications for cholecystectomy.

An important first step is to distinguish between the diffuse and focal forms of thickening. Subsequently, identification of ancillary imaging findings and the directed use of additional imaging modalities allow accurate diagnosis.


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