A Clinical Audit on Sonological Differential Diagnosis in Gall Bladder Wall Thickening
Keywords:
Gall Bladder thickening, Cholecystitis, Pain Per Abdomen, USG, Carcinoma, BMI.Abstract
Gallbladder wall thickening is a controversial topic among radiologist for being frequently found and for having been considered, for a long time, a sign highly suggestive acute cholecystitis. Such a concept has been undergoing changes as a result of a greater experience of the professionals involved in imaging diagnosis and the considerable technological development of ultrasonography (US) apparatuses.1 Ultrasonography is the initial imaging method for diagnostic approach and evaluation of the biliary system, as it is widely available, safe, innocuous and non-expensive.2 This method allows the detailed realtime study of the gallbladder, besides the evaluation of other findings that contribute to the final diagnosis, thus avoiding unnecessary cholecystectomies and their complications.3-5
OBJECTIVE: To enumerate the various clinical entities that may cause diffuse thickening of the gallbladder wall on Ultrasonography.
METHODS: A prospective study was conducted among 50 patients of all age and sex with right upper abdominal pain who were advised ultrasound imaging, selected through Simple Random Sampling. A predesigned, pretested, validated checklist was used to collect the required data from medical records of patients during the period of June 2011 – November 2013.Association between variables were estimated with Mc Nemar’s test.
RESULTS: Cholecystitis was found to be the most common cause of GB wall thickening followed by Dengue Viral Infection. The maximum GB wall thickness was found to be 11mm with maximum incidence noted at 5 mm. The incidence of GB wall thickening peaked in two age groups : 40-49 and 60-69 years.
CONCLUSION; As the results of the study suggest, secondary causes including type of food, BMi status of the patients, medications for other co-morbidities etc were statistically ssociated with mild thickening (4 -7 mm.) of gallbladder wall. However, primary causes like Cholecystittis, Carcinoma of the Gall bladder etc. were significantly associated with marked thickening og the gall bladder ( > 7mm.) , and with few causes of gall bladder growth showing (11 mm)of wall thickness. Ultrasonography is the method of choice for the study of the gallbladder, with a high sensitivity in the detection of gallbladder wall thickening. The correlation with other sonographic, clinical, laboratory and epidemiological findings is of utmost importance in order to avoid unnecessary cholecystectomies
