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Case of the Month

September 2015

Patient Data: 16 year old female patient

Clinical Info: Patient has vague abdominal complaints


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Thickened gallbladderwall in a young female patient


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Another image of the gallbladder. There are no stones.


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Image of the spleen with a small hypoechoic area


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Transverse image of the same spleen


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The hypoechoic area shows no vascularization


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The spleen measures more than 15 cm.


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Patient also has enlarged lymph nodes


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There is ascites


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This is the gallbladder of the same patient a few months later


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The ascites has gone


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The spleen is much smaller and the hypoechoic area is hardly seen. What do you think has happened


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This is the gallbladder of a 30 year old female patient with a thick gallbladderwall and multiple small gallstones. She has no signs of a cholecystitis, would you refer her to the surgeon anyway?


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Another image of the same patient


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Tranverse image


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The vena cava and liver veins are dilatated


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Another image of the liver


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The longitudinal image of the vena cava also shows a small pericardial effusion

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

For more cases of a thickened gallbladderwall without acute cholecystitis see

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