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 24 March 2018

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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.


Peter Devitt, Adelaide, Australia

Gastric volvulus and porcelain gallbladder.

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