From the Guidelines
Gallbladder distention on CT scan is a significant finding that warrants further evaluation, typically indicating an obstructive process, most commonly gallstones blocking the cystic duct, and requires prompt attention to prevent complications such as acute cholecystitis, perforation, or gallstone pancreatitis. When identified, further evaluation with ultrasound is recommended as the next step, as it provides better visualization of gallbladder pathology 1. The use of contrast-enhanced CT is very sensitive (74%-96%) and specific (90%-94%) for detecting biliary obstruction, and multidetector CT (MDCT) can determine the site and the cause of biliary obstruction more accurately than US 1. Some key points to consider in the management of gallbladder distention include:
- Laboratory tests including liver function tests, lipase, and white blood cell count should be ordered to assess for complications like cholecystitis or pancreatitis
- If the patient is symptomatic with right upper quadrant pain, nausea, or fever, prompt surgical consultation for possible cholecystectomy should be considered
- While waiting for definitive management, the patient should be kept NPO (nothing by mouth), given IV fluids, and prescribed pain medication as needed
- Antibiotics should be started if signs of infection are present, as the risk of complications such as cholangitis, cholecystitis, or pancreatitis is high 1. Gallbladder distention occurs when bile cannot properly exit the gallbladder, causing it to enlarge beyond its normal size, and this finding may be incidental in asymptomatic patients but requires attention to prevent serious complications 1.
From the Research
Distention of Gallbladder on CT
- The provided studies do not directly address the topic of distention of the gallbladder on CT.
- However, some studies discuss gallbladder disease and its management:
- A study published in 2022 2 discusses the use of antibiotics in patients undergoing cholecystectomy for gallbladder disease.
- Another study from 2020 3 explores alternative treatment options for high-risk surgical patients with acute cholecystitis, including percutaneous transhepatic gallbladder drainage and endoscopic gallbladder drainage.
- A comprehensive review of gallbladder disorders was published in 2021 4, covering various diseases and their management.
- A study from 2023 5 compares the outcomes of endoscopic retrograde cholangiopancreatography-guided gallbladder drainage and percutaneous cholecystostomy in acute cholecystitis patients.
- A meta-analysis published in 2024 6 evaluates the safety and efficacy of one-stage intraoperative ERCP combined with laparoscopic cholecystectomy versus two-stage preoperative ERCP followed by laparoscopic cholecystectomy in the management of gallbladder with common bile duct stones.
Relevant Findings
- While the studies do not specifically discuss distention of the gallbladder on CT, they provide information on gallbladder disease and its management, which may be relevant to understanding the context of gallbladder distention.
- For example, a distended gallbladder may be a sign of acute cholecystitis, which is discussed in several of the studies 2, 3, 5.
- However, without direct evidence on the topic of distention of the gallbladder on CT, it is not possible to provide a more specific answer.