Thick Gallbladder Wall on Ultrasound

Thick gallbladder wall is a common finding seen on ultrasounds done of the gallbladder. There are many causes of a thick gallbladder wall that range from benign all the way to a life threatening condition. A thick gallbladder wall is defined as one that is greater then 3 mm in thickness.

The gallbladder has to be distended in order to correctly measure the wall thickness. A contracted gallbladder after a meal may have a thick wall simply from being contracted. The symptoms you are having and any other medical conditions you may have are very important in trying to sort through the various causes. Some of the causes are from a diseased gallbladder and other causes are from diseases outside the gallbladder which cause wall thickening.

Acute cholecystitis or an inflamed gallbladder will cause wall thickening. This will however be accompanied by other findings in some cases such as gallstones, fluid around the gallbladder and pain in the right upper abdomen, especially when pressure is applied with ultrasound transducer. More chronically inflamed gallbladder can also cause wall thickening and is characterized by multiple previous episodes of pain.

Gallbladder cancer can cause thickening but this is more commonly in one part of the wall or looks more like a mass. Sometimes you see the mass going into the liver or big lymph nodes next to the gallbladder. The patients symptoms are also not of an acute inflammatory process and more longstanding.

Conditions such as liver disease also cause wall thickening of the gallbladder on ultrasound. Cirrhosis or a scarred end stage liver and hepatitis or inflamed liver can cause wall thickening of the gallbladder on ultrasound. In these cases, the patients clinical history and blood tests will be helpful.

Heart failure is another common condition which can cause gallbladder wall thickening on ultrasound. In these cases, the diagnosis may be known and the patient will not be complaining of right upper abdominal pain. Other helpful clues can be fluid in the lungs and distended veins in the liver.

An inflamed pancreas or pancreatitis can also cause a thickened gallbladder wall on ultrasound. Patients with AIDS and mononucleosis can have gallbladder thickening. Sometimes the cause of a thickened gallbladder wall may be simply the way a technologist measures the thickness or because the gallbladder is not well distended.

Gallbladder wall thickening has numerous causes and therefore associated findings, clinical history and physical exam findings become important in sorting through the causes. Additional tests like blood work, Nuclear scan, CT or MRI may add additional information when the cause is not clear.