Gastric volvulus and porcelain gallbladder.
An 89-year-old woman had been unable to tolerate solid meals for
many months. She had intermittent vomiting. The contrast study shows
a chronic gastric volvulus. In addition, a porcelain gallbladder was
present and also a duodenal diverticulum. The radiograph shows contrast
in the stomach, with the greater curve uppermost and within a large
hiatus hernial sac. The gallbladder is calcified. There is a small
puddle of contrast in the duodenal diverticulum, medial to the second
part of the duodenum. The patient declined any treatment.
Extensive intramural calcification may occur in up to 0.8% of resected
gallbladders. This process of calcification is commonly referred as
'porcelain gallbladder'. The term reflects the characteristic faint
bluish tinge to the gallbladder and its brittle consistency. Most
porcelain gallbladders are associated with gallstones, and the
significance of the condition is its association with malignancy. An
associated cancer of the gallbladder will be found in 10 - 20% of cases
of porcelain gallbladders. For this reason, cholecystectomy is
recommended - even in asymptomatic cases.
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