Porcelain Gallbladder
 

• Calcification of gallbladder wall
• So named because of its gross appearance and its similarity to porcelain
• Incidence:
  • Less than 1% of cholecystectomy patients
  • F:M  5:1
• Histology
  • Flakes of dystrophic calcium within chronically inflamed and fibrotic muscular wall
  • Wall is thickened and gallbladder is contracted
• Associated with gallstones in 90%
  • Cystic duct is always obstructed
  • 80% of patients with carcinoma of gallbladder have stones
• Minimal symptoms
• Imaging findings
  • Curvilinear calcifications in segment of the wall or entire wall

Plain film of abdomen shows a curvilinear calcification in the
right upper quadrant which corresponds to the location of the gallbladder

• Highly echogenic shadowing curvilinear structure in GB fossa
  • DDx: stone-filled contracted GB
• Echogenic GB wall with little acoustic shadowing
  • DDx: emphysematous cholecystitis
• Scattered irregular clumps of echoes with posterior acoustic shadowing

• Imaging pitfall
  • Contracted gallbladder with calcified wall can be mistaken for a gallstone
• Complication
  • 20-30% develop carcinoma of gallbladder