Adequate Management of Gallbladder Wall Thickening

Park, Eun Taek

Abstract

Thickening of the gallbladder wall is a relatively frequent finding on diagnostic imaging. Such thickening is also a common but nonspecific finding in many patients with intrinsic gallbladder disease and extracholecystic conditions. Wall thickening may be diagnostically problematic, occurring (as it does) in both symptomatic and asymptomatic patients and in those with and without indications for cholecystectomy. An important first step is to distinguish between the diffuse and focal forms of thickening. Subsequently, identification of ancillary imaging findings and the directed use of additional imaging modalities allow accurate diagnosis. This is of clinical importance. Misinterpretation of the cause of thickening can trigger unnecessary cholecystectomies in patients without intrinsic gallbladder disease. Also, misdiagnosis of patients who do in fact require cholecystectomy may delay treatment, thus increasing morbidity. Although a definitive imaging diagnosis may not be possible, the cause of gallbladder wall thickening can be determined in most instances by correlating the clinical presentation with associated imaging findings.