Gallbladder Mucocele Differential Diagnoses

Updated: Jun 08, 2017
  • Author: R Vijayaraghavan, MBBS, MS, FRCS(Edin); Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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DDx

Diagnostic Considerations

The diagnosis of a mucocele should be considered in the following instances:

  • Minimal acute inflammatory signs are present
  • A large, palpable, minimally tender gallbladder is found on clinical examination
  • Laboratory test results are normal or just within the upper limit of reference range values
  • Plain radiography of the abdomen shows a soft-tissue–density globular shadow in the subhepatic region
  • Ultrasonography of the right upper quadrant (RUQ) shows evidence of minimal wall thickening, an impacted stone in the neck, or infundibulum of an enlarged gallbladder and clear content
  • Intraoperatively, the aspirate from the gallbladder is clear and watery or mucoid (white bile)
  • Upon being opened, the gallbladder shows a white wall, clear and watery or mucoid content, a stone or stones impacted in the neck or cystic duct, a narrowed cystic duct, or a tumor or polyp causing obstruction of the neck of the gallbladder

Other problems to be considered in making the diagnosis include the following:

  • Hepatomegaly, choledochal cyst
  • Courvoisier gallbladder due to simultaneous obstruction of the gallbladder and common bile duct
  • Pseudocyst of the pancreas
  • Renal mass
  • Right suprarenal gland mass
  • Mesenteric cysts
  • Parasitic cysts - Hydatid cyst
  • Ascending colon mass