Differential Diagnosis for Gallstones Lodged in the Neck of the Gallbladder
- Single Most Likely Diagnosis
- Cholecystitis: This is the most likely diagnosis because gallstones lodged in the neck of the gallbladder can cause obstruction, leading to inflammation of the gallbladder, which is known as cholecystitis. The obstruction can lead to increased pressure and possible infection, making cholecystitis a common and direct consequence.
- Other Likely Diagnoses
- Biliary Colic: This condition occurs when a gallstone temporarily blocks the cystic duct or the common bile duct, causing severe pain. While it might not be as severe as cholecystitis, it's a common presentation for gallstones and can precede more serious conditions.
- Choledocholithiasis: If the stone moves from the gallbladder into the common bile duct, it can cause obstruction there, leading to jaundice, pain, and potentially pancreatitis. This is a likely diagnosis to consider because the stone's movement can lead to complications in the bile ducts.
- Do Not Miss Diagnoses
- Mirizzi Syndrome: Although less common, this condition occurs when a gallstone becomes impacted in the cystic duct and causes compression of the common hepatic duct, leading to obstructive jaundice. It's crucial not to miss this diagnosis due to its potential for severe complications, including bile duct injury.
- Gallbladder Cancer: While rare, cancer of the gallbladder can present with similar symptoms to those of gallstones, including obstruction. Given its poor prognosis if not caught early, it's essential to consider this in the differential diagnosis.
- Rare Diagnoses
- Porcelain Gallbladder: This is a rare condition where the gallbladder wall becomes calcified, often due to chronic inflammation. It can increase the risk of gallbladder cancer and is associated with gallstones, making it a rare but notable consideration.
- Phrygian Cap: This is an anatomical variation of the gallbladder that can sometimes be mistaken for a pathological condition. While not directly related to gallstones causing obstruction, it's a rare finding that might be encountered during imaging for gallbladder disease.