Learning Radiology xray montage
 
 
 
 
 

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

Porcelain Gallbladder. 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

porcelain gallbladder

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