Overview
What are the signs and symptoms of gallbladder mucocele?
Which physical findings are characteristic of gallbladder mucocele?
What is the role of lab testing in the diagnosis of gallbladder mucocele?
What is the role of imaging studies in the diagnosis of gallbladder mucocele?
What is the definitive treatment for gallbladder mucocele?
What are the surgical options for the treatment of gallbladder mucocele?
What is the pathophysiology of gallbladder mucocele?
What causes gallbladder mucocele?
Which conditions are associated with gallbladder mucocele in infants and children?
What is the prevalence of gallbladder mucocele?
What is the prognosis of gallbladder mucocele?
Presentation
Which clinical history findings are characteristic of gallbladder mucocele?
Which physical findings are characteristic of gallbladder mucocele?
DDX
When should a diagnosis of gallbladder mucocele be considered?
What conditions should be included in the differential diagnoses of gallbladder mucocele?
Workup
What is the role of lab testing in the diagnosis of gallbladder mucocele?
What is the role of ultrasonography in the diagnosis of gallbladder mucocele?
What is the role of imaging studies in the diagnosis of gallbladder mucocele?
Treatment
How is gallbladder mucocele treated?
What is the role of cholecystectomy and cholecystostomy in the treatment of gallbladder mucocele?
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Image is from a 35-year-old woman who presented with recurrent episodes of right upper quadrant colic; most recent attack was 3 days before. Gross wall thickening is apparent; this is usually measured on anterior wall of gallbladder. Also apparent are clear content, stone in neck of gallbladder, and absence of pericholecystic fluid. All favor diagnosis of acute cholecystitis.
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Stone in neck of gallbladder, with postacoustic shadowing. Minimal wall thickening and dilated gallbladder suggest mucocele.
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Transverse scan shows stone in neck of gallbladder, with postacoustic shadowing. Minimal wall thickening and dilated gallbladder are also visible.
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Transverse scans show layering of gallbladder wall; this suggests edema and indicates acute cholecystitis.
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Longitudinal scan shows layering, with fluid in wall of gallbladder and impacted stone in neck of gallbladder. Intraluminal shadowing indicates sediments in fluid; image indicates acute cholecystitis with possible pyocele of gallbladder.
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Cluster of impacted calculi in neck of gallbladder, minimal wall thickening, and clear content; this indicates mucocele of gallbladder.
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Cluster of calculi with postacoustic shadowing in neck of gallbladder, normal wall, and clear content; this indicates mucocele of gallbladder.
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Distended gallbladder with evidence of adhesions on its wall. Irregular surface indicates recurrent attacks of cholecystitis.
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Yellowish aspirate from gallbladder of a 28-year-old woman who presented with features of right upper quadrant peritonitis. Slightly yellowish fluid was sterile and was rich in cholesterol.
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Subserosal perforation of acute, emphysematous, acalculous cholecystitis in a 58-year-old diabetic man. Patient presented with features suggestive of ileus. He had high intrathoracic liver (and gallbladder), and clinical signs were atypical. Green color is unusual.
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Laparoscopic view of distended gallbladder in woman aged 70 years with sudden onset of severe right upper abdominal pain.
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Stone being extracted from cystic duct through small ductotomy.
