Karki S, Bohara S, Upadhaya Regmi B, Bhat PS, Malla S, Mainali G, Khatri S, Rawal SB. Cholecystopathia chronica calcarea (Porcelain gall bladder): A case report from Nepal.
Ann Med Surg (Lond) 2022;
84:104947. [PMID:
36582857 PMCID:
PMC9793149 DOI:
10.1016/j.amsu.2022.104947]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/02/2022] [Accepted: 11/13/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction and importance
Porcelain gall bladder is an uncommon end-stage modification of chronic cholecystitis, with an incidence ranging from 0.06 to 0.8% along with a plausibility of malignant transformation.
Case presentation
We present a 55-year-old female presenting with complaints of epigastric and right hypochondriac region pain who underwent prophylactic laparoscopic cholecystectomy after making a provisional diagnosis of calcified gall bladder on a computed tomography workup. On histopathological examination, she was later diagnosed with a porcelain gallbladder devoid of features suggestive of malignant transformation.
Clinical discussion
Porcelain gallbladder is a cholecystopathological condition in which the gallbladder wall gets calcified, either completely or partially. Though the exact pathomechanism of gallbladder calcification is unknown, it is believed to be due to chronic inflammation. Recent studies have shown that gallbladder calcification is associated with a lower risk of the development of gallbladder cancer. Imaging studies, followed by post-operative histopathological examinations, are used to diagnose the porcelain gallbladder. Though the management of asymptomatic patients is debatable, prophylactic cholecystectomy is the preferred treatment for symptomatic porcelain gallbladder patients.
Conclusion
Individual porcelain GB patients should be addressed based on the presenting condition, whether surgically or via clinical monitoring and follow-up, taking into consideration the advantages and limitations of both treatment modalities.
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