Gallbladder wall thickness (GBWT) and serum albumin were determined in 54 patients with ascites. The statistical analysis of the results reveals a significant difference in GBWT between benign and malignant conditions ( p < 0.01). GBWT was significantly thicker in patients with cirrhosis than in those with malignant ascites ( p cO.01) and other benign conditions. However, no significant differences were found between either cirrhotic cases with and without overlying hepatocarcinoma, or between noncirrhotic patients, malignant or otherwise. On comparing GBWT and simple routine sonography in establishing the etiology of ascites, the diagnostic reliability indices decreased with GBWT. This shows that GBWT determination lacks diagnostic importance in routine practice.
No correlation was found between serum albumin and GBWT, which suggests that the increase in GBWT observed in cirrhotic patients is mainly the result of accompanying portal hypertension. Indexing Words: Gallbladder wall thickness . Ultrasound studies -Ascites, malignant . Cirrhosis of liver A number of authors have found that increases in gallbladder wall thickness (GBWT) may be related not only to intrinsic gallbladder pathology but also to conditions not directly related to biliary pathology.'.' An increase in GBWT has been described under circumstances as diverse as acute hepatitis, chronic alcoholic liver pathology, portal hypertension, hypoproteinemia, multiple myeloma, congestive heart failure, and chronic renal insuffi~iency.l-~ Tsujimoto et a1.6 have recently attempted to establish a correlation between GBWT and the etiology of ascites. These authors suggested that in the absence of hypoalbuminemia, the benign causes of ascites (mainly cirrhosis with portal hypertension in their series) would be accompanied by a thickened wall, whereas with malignant etiologies (mainly metastasis) GBWT would be normal. They found a statistically significant relationship between these two parameters and From the Departments of *Radiology and tClinica1 Biopa-