41 Filling Defects in an Opacified Gallbladder

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig GI 41-1 Multiple radiolucent gallstones, many of which contain a central nidus of calcification.

• Fig GI 41-2 Layering of gallstones. (A) With the patient supine, the stones are poorly defined and have a gravel-like consistency. (B) On an erect film taken with a horizontal beam, the innumerable gallstones layer out and are easily seen.

• Fig GI 41-3 Fissuring in a gallstone. Mercedes-Benz sign (arrow). Note the adjacent gallstone with a radiopaque rim.

• Fig GI 41-4 Cholesterol polyp (arrow).

• Fig GI 41-5 Solitary adenomyoma. A broad mass (arrow) is evident at the tip of the fundus of the gallbladder.

• Fig GI 41-6 Adenomyomatosis. Rokitansky-Aschoff sinuses are scattered diffusely throughout the gallbladder. The collections of intramural contrast material appear to parallel the opacified gallbladder lumen (arrows), from which they are separated by a lucent space representing the thickness of the mucosa and muscularis.

• Fig GI 41-7 Carcinoma of the gallbladder. Irregular mural mass (arrow) with tumor growth extending into the cystic duct.