Air In and Around the Gallbladder
The Common Vein Copyright 2008
Causes of air in and around the gallbladder ranges from benign accumulation in gallstones to severe emphysematous cholecytitis. Air in the wall is always abnormal, but air in the lumen needs careful clinical input since it may be benign or underlie severe disease.
Emphysematous cholesystitis is a severe anerobic infection of the gallbladder most commonly seen in diabetic patients. The air can accumulate in the wall or may accumulate in the lumen. Other pathological causes include trauma and gallstone ileus. Rare causes include liver abscess and cholangitis. Air in the biliary tree and gallbladder is commonly seen post ERCP.
Diagnosis requires imaging and although plain film can make the diagnosis, CT is the more senstive to small amounts of air. Ultrasound can be helpful but air usually shadows to the extent that it may be difficult to definitively identify.
Treatment for emphysematous cholecystitis is emergency surgery.
|82384.6ks 78M air in gallbladder wall abdominal pain emphysematous cholecystitis CTscan copyright 2008 Courtesy Ashley Davidoff MD|
|Emphysematous Cholecystitis Air in Lumen and Wall|
|16195c01.8s elderly patient with heart disease and significant atherosclerotic disease gallbladder lumen is filled with air wall linear air collection bubbles of air air fluid level dx emphysematous cholecystitis CTscan Courtesy Ashley Davidoff MD copyright 2008|
|Emphysematous Cholecystitis Air in Lumen and Wall – Plain Film|
|04537c02s air in the gallbladder wall air in the lumen dx emphysematous cholecystitis gallbladder wall lumen plain X-ray lateral abdominal projection Courtesy Ashley DAvidoff MD copyright 2008|
|Emphysematous Cholecystitis Air in Lumen Air Fluid Level
Air in Wall
|04541c01s air in the gallbladder wall air in the lumen air fluid level dx emphysematous cholecystitis gallbladder wall lumen plain X-ray decubitus right side up lateral abdominal projection Courtesy Ashley DAvidoff MD copyright 2008|
|Bullet Wound – Emphysematous Cholecystitis Air in Wall|
|04641c01.8s gunshot wound to the abdomen gallbladder air in wall emphysematous cholecystitis fragments of bullet plain X-ray Courtesy Ashley Davidoff MD Copyright 2008|
|26909c04.8s gallbladder air stomach duodenum thickened dx penetrating ulcer dx cholecystoduodenal fistula IVC inferior vena cava filteer small prominent folds valvulae conniventes ascites CTscan C+ Courtesy Ashley Davidoff MD copyright 2008|
|31127c02.8s gallbladder stones air adherent to duodenum small bowel dilatation calcification stone gallstone ileus CTscan Courtesy Ashley DAvidoff copyright 2008|
|47221c01s gallbladder air cystic duct iatrogenic bile duct ERCP Courtesy Ashley Davidoff MD copyright 2008|
|22333 gallbladder + fx air + imaging radiology CTscan C- probably post ERCP|
|Bowel Ischemia and Air in the Gallbladder|
|16310c01.8 liver portal vein air gallbladder colon pneumatosis coli superior mesenteric vein SMV bowel ischemia ischemic bowel bowel infarction CTscan Courtesy Ashley DAvidoff MD copyright 2008|
|81901.8s gallbladder hemorrhagic cholecystitis cholecystostomy further hemorrhage air iatrogenic catheter CTscan Courtsesy Ashley Davidoff MD copyright 2008|
|31188a02 Courtesy Ashley Davidoff MD pancreas head body fx exudate dx acute pancreatitis imaging radiology CTscan inflammation gallbladder fx air post endoscopy|
|Floating and Gas Filled Stones|
|26540 gallbladder + fx filling defects + fx air + fx floating + dx cholelithiasis + imaging radiology CTscan C-|
|Subtle Character Changes MinimalAmount of Air in a Floating Stone|
|70269c02 gallbladder air methane nitrogen gas cholesterol stone isodense with bile fat subtle change CTscan|
|Reflux Through Incompetent Ampulla|
|82178c01.8s air gallbladder contracted small chronic cholecystitis left intrahepatic bile ducts nephrolithiasis CTscan Courtesy Ashley Davidoff MD copyright 2008|
|Reflux Through Stent|
|16311.8s gallbladder bile duct air fx air biliary stent dx reflux of air into the cystic duct and gallbladder CTscan Courtesy Ashley Davidoff MD copyright 2008|
|Abscess in the Gallbladder Fossa s/p Cholecystectomy|
|The CTscan represents an abscess in the post operative bed of a patient who had undergone cholecystectomy. The post op fossa and abscess has the same pyriform shape as the gallbladder and contains a fluid collection with bubbles of air characteristic of an infection with anerobic organisms. the bubbles although floating to the top are not quite free to form an air fluid layer indicating complex fluid probably with thick pus and fibrinous strands. Percutaneous drainage is indicated.
of a different type 77668.8s gallbladder gallbladder fossa s/p cholecystectomy skin bile duct stent air fluid air fluid level s/p cholecystectomy abscess in post operative bed CTscan Courtesy Ashley DAvidoff MD copyright 2008
|Gallbladder Perforation and pericholecystic abscess|
|16254c01b02.8s gallbladder thickened irregular wall air anterior wall small fluid collection gallbladder carcinoma complicated by perforation and abscess formation CTscan Courtesy Ashley Davidoff copyright 2008|
|46625 gallbladder fossa s/p cholecystectomy with gelfoam packing of fossa fx echgenic collection in gallbladder fossa dx air within gelfoam USscan Davidoff MD|
Reference: Reuter: Der Groe Reuter. Springer Universalworterbuch Medizin, Pharmakologie Und