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September 2015

Thickened gallbladderwall and a splenomegaly in a young female patient
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Clinical information

Patient has vague abdominal complaints.

Ultrasound Images & Clips

Thick gallbladderwall and splenomegaly in a young patient

Thickened gallbladderwall in a young male patient
Thickened gallbladderwall in a young male patient
Another image of the gallbladder. There are no stones.
Another image of the gallbladder. There are no stones.
Image of the spleen with a small hypoechoic area
Image of the spleen with a small hypoechoic area
Transverse image of the same spleen
Transverse image of the same spleen
The hypoechoic area shows no vascularization
The hypoechoic area shows no vascularization
The spleen measures more than 15 cm.
The spleen measures more than 15 cm.
Patient also has enlarged lymph nodes
Patient also has enlarged lymph nodes
There is ascites
There is ascites
This is the gallbladder of the same patient a few months later
This is the gallbladder of the same patient a few months later
The ascites has gone
The ascites has gone
The spleen is much smaller and the hypoechoic area is hardly seen
The spleen is much smaller and the hypoechoic area is hardly seen
This is the gallbladder of a 30 year old female patient with a thick gallbladderwall and multiple small gallstones. She has no clinical signs of a cholecystitis, would you refer her to the surgeon immediately anyway?
This is the gallbladder of a 30 year old female patient with a thick gallbladderwall and multiple small gallstones. She has no clinical signs of a cholecystitis, would you refer her to the surgeon immediately anyway?
Another image of the same patient
Another image of the same patient
Tranverse image
Tranverse image
The vena cava and liver veins are dilatated
The vena cava and liver veins are dilatated
Another image of the liver
Another image of the liver
The longitudinal image of the vena cava also shows a small pericardial effusion
The longitudinal image of the vena cava also shows a small pericardial effusion

Conclusion

A thickened gallbladder wall can have different causes and doesn't have to mean that there is an acute cholecystitis.
The first patient had a mononucleosis infect with lymphadenopathy, peritoneal fluid, splenomegaly and a small splenic infarct. The second patient had gallstones but no cholecystis but a cardiological problem with a thickened gallbladderwall because of this.

Details

  • Sex: Female
  • Age: 16

Created with

  • Fujifilm Ultrasound System
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photo Taco Geertsma
Author

Dr. Taco Geertsma

Retired Radiologist, Gelderse Vallei Hospital

Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.

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