Porcelain Gallbladder

1. Pathogenesis:

• Unknown etiology, most likely due to chronic gallbladder inflammation and gallstones. Women are most frequently affected.
   
• Porcelain gallbladder refers to the calcification in the wall of the gallbladder. The metaphor refers to the brittle nature of the calcified wall.
   
• Usually, the patient does not have many symptoms, and the case is discovered upon incidental radiograph or CT.
   
• A patient with porcelain gallbladder almost always has gallstones along with cystic duct obstruction.
   
• Calcification may occur within the muscular layer or within the glands of the gallbladder mucosa.
   
• Calcification within the muscular layer is usually continuous and smooth.
   
• 10 to 20% of all patients with porcelain gallbladder develop gallbladder cancer during their lifetime—prophylactic cholecystectomy is recommended.
   

2. Radiographic findings:

• Plain film: extensive calcification is apparent around the perimeter of the gallbladder.



• U/S: bright, echogenic gallbladder wall with posterior shadowing in the gallbladder fossa.

             

• CT: Calcification of the gallbladder wall (arrows), often accompanied by stones.