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Plain abdominal radiograph of an 84-year-old woman who presented with a three-month history of diffuse abdominal pain and weight
loss of 40 pounds. On physical examination, she had a hard, nontender, baseball-sized mass in the right upper abdominal quadrant.
- Diagnosis
A computed tomographic scan showed that the calcification seen on the plain abdominal radiograph represented the wall of
the gallbladder (image below). The scan also showed ascites, multiple lesions in the liver, and nodularity of the
peritoneum and small bowel mesentery. These findings suggested metastatic carcinoma of the gallbladder, but the patient
refused further investigation.
- More
Calcification of the gallbladder wall—referred to as “porcelain gallbladder”— is a rare form of chronic cholecystitis
affecting women predominantly. It should always be considered in the differential diagnosis of a calcified lesion in the
right upper abdominal quadrant. Confirmation of porcelain gallbladder can be achieved by ultrasonography or computed
tomography. Because patients with a calcified gallbladder have an increased risk of gallbladder cancer, cholecystectomy
is indicated in most cases.
Source: Images of Memorable Cases: Case 19
Date: 4 Desember 2008.
Author: Herbert Fred, Hendrik van Dijk
Licence: Creative Commons Attribution 2.0 License
Reference: Fred, H.; van Dijk, H. Images of Memorable Cases: Case 19, Connexions Web site. http://cnx.org/content/m14939/1.3/, Dec 4, 2008
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