PMC3168393_01
(a) Gallbladder swelling cannot be seen on baseline abdominal CT before sorafenib administration. (b) A highly tense and enlarged gallbladder can be seen on abdominal CT. There is no thickening of the gallbladder wall. The intrahepatic and common bile ducts are not dilated, and there are no calculi in the gallbladder or tumorous lesions in the neck of the gallbladder.
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fig1
Abdominal plain computed tomography revealed a markedly enlarged gallbladder (Figure 1), and abdominal ultrasound (Figure 2) revealed biliary debris without calculi.
Clear thickening of the gallbladder wall cannot be seen on abdominal ultrasonography, but echoes from biliary debris can be seen inside a highly tense and enlarged gallbladder. Clear elevated lesions and calculi cannot be seen in the gallbladder.
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fig2
Abdominal plain computed tomography revealed a markedly enlarged gallbladder (Figure 1), and abdominal ultrasound (Figure 2) revealed biliary debris without calculi.
(a) Gallbladder swelling with wall thickness remained on abdominal CT 30 days after admission. (b) Gallblader and cystic duct were not visualized on three-dimensional spiral CT cholangiography.
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fig3
The cholecystitis resolved immediately postoperatively, but the gallbladder remained enlarged (Figure 3), and the RUQ discomfort persisted.
(a) Changes due to chronic cholecystitis can be seen: proliferation of fibromuscular tissue and formation of Rokitansky-Aschoff sinuses can be seen on the gallbladder wall. (b) Occluded arterioles with thickened vascular endothelium can be seen in the muscular layer of the gallbladder.
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fig4
There was also sporadic arteriolar occlusion associated with intimal thickening in the muscular layer of the gallbladder (Figure 4).