Utility of sono-graphic gallbladder wall patterns in differentiating malignant from cirrhotic ascites
✍ Scribed by Yi-Shin Huang; Shou-Dong Lee; Jaw-Ching Wu; Sun-Sang Wang; Han-Chieh Lin; Yang-Te Tsai
- Publisher
- John Wiley and Sons
- Year
- 1989
- Tongue
- English
- Weight
- 526 KB
- Volume
- 17
- Category
- Article
- ISSN
- 0091-2751
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✦ Synopsis
Thirty-one patients with ascites associated with malignancy and 49 patients with cirrhotic ascites were enrolled in a sonographic study of the gallbladder wall. Three gallbladder wall patterns were recognized: A, single-layered, nonthickened wall; B, single-layered, thickened wall; and C, double-layered, thickened wall. Pattern A was found more frequently in patients with malignant ascites, while patterns B and C were detected more frequently in patients with cirrhotic ascites. If "nonthickened gallbladder wall" is used as a criterion for prediction of malignant ascites, the sensitivity is 80.6% and the specificity 93.9%. This suggests that sonographic examination of the gallbladder wall is useful in the differentiation of malignant from cirrhotic ascites. Indexing Words: Gallbladder wall thickening Ultrasonography * Ascites Over the past two decades, sonography has evolved from being mainly a research instrument to becoming an indispensible diagnostic tool. Several studies report sonographic evidence of gallbladder wall thickening in patients with various biliary and nonbiliary diseases, including acute cholecystitis, 1-3 chronic c h o l e c y ~t i t i s , ~~~ hyp~albuminemia,~'~ hepatitis,6-8 alcoholic liver d i ~e a s e , ~ chronic heart failure,l0,l1 renal insufficiency,l0'l1 portal and as-Given a serum albumin level equal to or greater than 2.5 mg/dL, Tsujimoto et al.13 first demonstrated that a sonographically singlewalled gallbladder in the presence of ascites indicates carcinomatous peritonitis, and a thickened, double-walled gallbladder indicates nonmalignant ascites.
Ascites is a frequently encountered problem in the daily practice of a gastroenterologist, and the nature of ascites is critical in determining the management and prognosis of patients. The con-
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