CT scan on gallbladder
DEAR DR. ROACH: What does “thickening” mean regarding a CT scan of a gallbladder? Does this call for a biopsy? What is cholelithiasis?
ANSWER: We don’t often think of the gallbladder when everything is going well. The gallbladder is a fairly simple organ, whose job is to store the bile made in the liver. When we eat, the gallbladder releases the bile at the right time to help us digest food, especially fats, properly.
By far, the most common problem of a gallbladder is the presence of gallstones. These crystals of bile salts and cholesterol can block the bile ducts, so when the gallbladder squeezes to release bile, it causes pain, usually in the area of the gallbladder, which is in the right upper quadrant of the abdomen. The symptoms are most likely to come after a fatty meal, which is a strong stimulus to the gallbladder to squeeze.
Gallstones (choleliths, literally “bile stones” from Greek) can be seen in the gallbladder by an imaging study, such as ultrasound, but thickening of the gallbladder wall is highly suggestive that the gallbladder has been squeezing against a blockage.
In a person with symptoms suggestive of inflammation of the gallbladder (“cholecystitis”) and presence of gallstones (“cholelithiasis”), definitive surgery to remove the gallbladder would normally be the next step, rather than biopsy.
People with focal thickening of the gallbladder wall but without symptoms of cholecystitis might be suspected of a gallbladder tumor, and biopsy might be indicated in that situation.
Incidentally, some people may wonder how the body manages without a gallbladder. The liver takes over the job of releasing bile at the right time, and most people will have no further symptoms within a few months of surgery.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth @med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803.