Porcelain Gallbladder

Extensive calcium encrustation of the gallbladder wall has been called a “porcelain gallbladder”.  At surgery there is a blue discoloration and brittle consistency of the gallbladder wall.  The true incidence of porcelain gallbladder is unknown, but it is reported to be 0.6-0.8%, with a male-to-female ratio of 1:5. Most porcelain gallbladders (90%) are associated with gallstones.

Diseases associated with this includes large gallbladder opaque calculi, milk-of-calcium bile.

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Patients with porcelain gallbladder are usually asymptomatic, and the condition is usually found incidentally on plain abdominal radiographs, sonograms, or computed tomography (CT) images.

Surgical treatment of porcelain gallbladder is based on results from studies performed in 1931 and 1962, which revealed an association between porcelain gallbladder and gallbladder carcinoma. Porcelain gallbladder is an uncommon condition; recognizing the clinical and imaging characteristics of the disease is important because of the high frequency (22%) of adenocarcinoma in porcelain gallbladder.  Nonetheless, the causal relationship between porcelain gallbladder and malignancy has not been established.

Surgery should not be delayed even if the patient is asymptomatic, because the occurrence of carcinoma in porcelain gallbladder is remarkably high. (adapted from emedicine)

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