This Article Abstract Full Text Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Zissin, R Articles by Gayer, G Search for Related Content PubMed PubMed Citation Articles by Zissin, R Articles by Gayer, G

CT of a thickened-wall gall bladder

¹ Department of Diagnostic Imaging, Sapir Medical Center, Kfar Saba 44281 and ² Department of Diagnostic Imaging, Assaf Harofe Medical Center, Zrifin, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

View larger version (121K): [in a new window]   Figure 1. A 75-year-old woman with acute cholecystitis. Contrast enhanced CT shows a distended gallbladder with mural thickening of soft tissue density, pericholecystic stranding (arrowhead) and reactive thickening of the adjacent colonic wall at the hepatic flexure (arrow).

View larger version (132K): [in a new window]   Figure 2. An 81-year-old with acute cholecystitis. Contrast enhanced CT shows a "sandwich-like" thickening of the gallbladder wall, representing hypodense submucosal oedema surrounded by an inner layer of enhancing mucosa (arrow) and an outer layer of enhancing serosa (arrowhead).

View larger version (98K): [in a new window]   Figure 3. A 76-year-old woman with acute cholecystitis. (a) Contrast enhanced CT shows a distended gallbladder (GB) with "sandwich-like" mural thickening, pericholecystic stranding of inflammatory changes and indistinct interface between the GB and the adjacent liver (arrows). (b) 2 cm caudally to (a), marked pericholecystic inflammatory changes (arrowheads) are seen with reactive thickening of the adjacent duodenum (D). (c) 2 cm caudally to (b), reactive mural thickening of the juxtaposed hepatic flexure (C) is demonstrated.

View larger version (125K): [in a new window]   Figure 4. A 28-year-old man with drug-induced hepatitis. Contrast-enhanced CT shows a "halo-like" thickening of the gallbladder wall, representing the enhancing mucosa (arrowhead) surrounded by subserosal oedema.

View larger version (112K): [in a new window]   Figure 5. A 71-year-old man with acute cholecystitis. Contrast-enhanced CT shows a distended thickened-wall gallbladder with a fluid–fluid level of high-attenuation bile (arrow). Note the focal increased attenuation within the adjacent liver parenchyma (arrowheads) representing reactive hepatic arterial hyperaemia.

View larger version (121K): [in a new window]   Figure 6. A 85-year-old woman with acute gangrenous cholecystitis. Contrast enhanced CT shows a distended gallbladder with gas-containing gallstones. Halo-like mural thickening with interrupted mucosa (curved arrow) is seen, compatible with necrotizing, gangrenous cholecystitis.

View larger version (128K): [in a new window]   Figure 7. A 74-year-old man with acute emphysematous cholecystitis. CT shows gas within a thickened gallbladder wall (arrows) containing a large gallstone (arrowhead). Note the pericholecystic dissection of the gas (G).

View larger version (131K): [in a new window]   Figure 8. A 93-year-old woman 10 days after surgery for perforated duodenal ulcer presented with fever and pus discharge through operative sutures. Contrast enhanced CT shows gas bubbles and extravasation of the orally ingested contrast medium (black arrow) reaching the skin (white arrow), compatible with leak and cutaneous fistula. Reactive "sandwich-like" thickening of the gallbladder wall is seen.

View larger version (100K): [in a new window]   Figure 9. A 36-year-old woman with acute pancreatitis. Contrast enhanced CT shows a thickened gallbladder wall with enhancing, thickened mucosa (arrowhead) and subserosal oedema. Note enlargement of the pancreatic head and the peripancreatic fluid (arrow).

View larger version (123K): [in a new window]   Figure 10. A 57-year-old woman with acute pyelonephritis. Contrast enhanced CT at the mid-abdomen shows a halo-like thickening of the gallbladder wall, ascitic fluid and hypodense lesions within the enlarged right kidney (arrowheads).

View larger version (148K): [in a new window]   Figure 11. A 73-year-old man with liver cirrhosis. Contrast enhanced CT shows thickening of the gallbladder wall of soft-tissue density (arrowhead), ascites, splenomegaly and atrophic liver with lobular borders.

View larger version (59K): [in a new window]   Figure 12. A 79-year-old woman with right-sided heart failure. (a) Contrast enhanced CT at the level of the upper abdomen shows "geographic" appearance of the congested liver and bilateral pleural effusions. (b) At a lower level, a thickened-wall gallbladder with enhancing mucosa (arrows) subserosal oedema is seen as well as ascitic fluid.

View larger version (142K): [in a new window]   Figure 13. A 31-year-old HIV positive man presented with jaundice and abnormal liver function tests. Contrast enhanced CT shows splenomegaly a distended, thick-walled gallbladder (asterisk), which was further confirmed at surgery. Histology revealed acute and chronic inflammatory changes with a positive immunoperoxidase stain for Cytomegalovirus.

View larger version (110K): [in a new window]   Figure 14. A 25-year-old woman presented with fever and abdominal tenderness 2 days following penetrating trauma in the right upper quadrant (RUQ). Contrast-enhanced CT shows gallbladder (GB) wall thickening (asterisk) with intraluminal bile-blood level (arrowhead), infiltration within the posterior pericholecystic tissue (black arrow) and the RUQ subcutaneous defect (white arrow) indicating the stab wound. At surgery two lacerations were found within the anterior and posterior aspect of the GB with mild biliary peritonitis.

View larger version (120K): [in a new window]   Figure 15. A 67-year-old woman with gallbladder (GB) carcinoma. Contrast enhanced CT shows multiple metastatses (black arrows) within the liver and a thick-walled GB with irregular mucosal (white arrows) thickening and polypoid masses (arrowhead) of soft-tissue density within the subserosal oedema (asterisk).