Porcelain gallbladder (PGB) is also referred to as gallbladder calcification. This condition results from calcium encrusting the inner gallbladder wall (Jones et.al., 2022). Many do not take gallbladder calcification seriously because of the low occurrence rate of 0.06% to 0.8% (Lee et.al., 2005). Although the etiology of gallbladder calcification remains unknown, the condition displays a similar mechanism of gallstones (Jones et.al., 2022), and PGB is often associated with gallstones in about 95% of cases (i.e. the hardening of bile stored in the gallbladder due to the high presence of bilirubin, cholesterol, or bile salt) which eventually is associated with the development of cancer in the gallbladder (Morimoto et.al., 2021).
This is a cause for concern because many PGB patients are normally diagnosed via incidental radiography meaning, these patients go asymptomatic with the condition until it is worse or caught in search of another diagnosis (Morimoto et.al., 2021). Researchers report that there is a 5:1 female predominance over males and about 6 million men, as well as 14 million women between the ages of 20 to 74, tend to have gallstones (Jones et.al., 2022). Since prevalence increases with age and the number of individuals with gallstones is extremely high, prolonged presence becomes a major factor in the progression of gallbladder calcification.
It is important to seek medical attention if you experience sudden pain in your upper left side that doesn't go away, especially if you have had cirrhosis or any other type of liver disease before. Other symptoms may include nausea, vomiting, abdominal pain, and fever.
Oftentimes, PGB is misdiagnosed with palpable masses such as neoplastic growth, abdominal hernias, or lipomas. Other differential diagnoses may include calcified renal cysts, pancreatic degenerative cystic lesions, echinococcal cysts, calcified adrenal tumors, etc (Jones et.al., 2022).
Some noncancerous PGB patients are treated with cholecystectomies while others undergo cholecystitis surgery. These two patients tend to have very good prognoses while cancerous PGB patients have much worse prognoses. Just like any other cancer, the survival rate depends on the stage it’s at, and stage 1 of cancerous PGB patients have a 50% 5-year survival rate, stage 2 has 28%, stage 3 has 8%, and stage 4 has a 2% survival rate (Jones et.al., 2022).
CITATION:
Jones MW, Weir CB, Ferguson T. Porcelain Gallbladder. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518979/
Lee, T.-C., Liu, K.-L., Lai, I.-R., & Wang, H.-P. (2005). Diagnosing porcelain gallbladder. The American Journal of Medicine, 118(10), 1171–1172. https://doi.org/10.1016/j.amjmed.2005.04.023
Morimoto, M., Matsuo, T., & Mori, N. (2021). Management of Porcelain Gallbladder, Its Risk Factors, and Complications: A Review. Diagnostics, 11(6), 1073. https://doi.org/10.3390/diagnostics11061073
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ReplyDeleteYour title is really catchy! You mentioned in your post that most patients tend to be asymptomatic. The problem with asymptomatic diseases is that by the time the individual seeks medical care, the disease may have already progressed to advanced stages, which might make the disease harder to treat and manage at that point. Routine medical care/screening may help identify signs & symptoms and halt the progression earlier on. But what about individuals living in developing countries who may not be able to easily access health care services due to barriers like cost, physical distance to the health care facility etc which then prevent them from seeking health care in a timely manner? This is something to think about.
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