Porcelain Gallbladder

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.

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.