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Computer tomography of the gallbladder
Last reviewed: 23.04.2024
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After the imposition of choledochoenteroanastomosis, sphincterotomy or endoscopic retrograde pancreatocholangiography (RPHG), hypodense air bubbles usually appear in the lumen of the intrahepatic bile ducts. This presence of air should always be differentiated from gas due to the development of an abscess in an anaerobic infection.
Enlargement of intrahepatic bile ducts is called cholestasis. It can develop as a result of blockage of the bile ducts by concrements or neoplasm (bile ducts, pancreas, falcon papilla).
If surgically, cholestasis can not be eliminated, a stent is implanted to decompress the bile ducts.
Gallbladder
The shape and size of the gallbladder depends on the time elapsed since the last meal. The diagnosis of edema of the gallbladder is established only with a pronounced enlargement, when its dimensions in several projections exceed 5 cm. Usually the coefficient of bile weakening is slightly above water (0 HU), but the thickening of bile leads to its increase to 25 HU.
Cholelithiasis
In the lumen of the gallbladder, concrements with calcification of varying degrees of severity can be determined. In bilirubin and cholesterol concretions, goblet or annular calcification is usually seen). If the concrements block the bladder duct or if stenosis develops due to sedimentation, sedimentation of bile of increased density - "slaj" - can develop. The concrements in the common bile duct are best detected with thin sections. This is due to the fact that on slices of standard thickness small concretions are easy to miss.
Chronic inflammatory processes
Cholecystolithiasis leads to chronic inflammation of the gallbladder with filling by its calculi, wrinkling, development of acute cholecystitis or empyema (determined by an unevenly thickened wall). Chronic inflammatory process increases the risk of malignant degeneration of tissues. The development of a porcelain gallbladder with calcification in the form of a shell can be regarded as a precancerous condition.
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