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Intrahepatic gallbladder

Posted Tue, 08/04/2009 - 05:55 by Shweta Bhatt
Images

Fig 1. Axial CT.

Fig 2. Coronal reconstruction.

Fig 3. Transverse Ultrasound of the gallbladder.


Clinical History:

23 year old male with chest pain.


Findings:

Figures 1 and 2. Contrast enhanced CT , axial and coronal images, demonstrate a focal cystic lesion within the liver parenchyma , consistent with an intrahepatic location of the gallbladder.

Figure 3. Ultrasound of the liver confirms the intrahepatic location of the gallbladder.


Diagnosis:

Intrahepatic gallbladder


Discussion:

Intrahepatic gallbladder is one of the ectopic locations of the gallbladder, where the gallbladder lies within the liver parenchyma. Intrahepatic gallbladders have a subcapsular location along the anterior inferior right
lobe of the liver (1). Occassionally , a small portion of the intrahepatic gallbladder may protrude from the liver. This type of gallbladder results form a developmental anomaly, or a congenital arrest which prevents the gallbladder form its intrahepatic position in the second month of gestation to its normal superficial location.
Intrahepatic gallbladder can be readily imaged and identified by either ultrasound or CT. The position of the gallbladder and the surrounding liver parenchyma suggests the diagnosis.

On nuclear scinitigraphy, this may mimic a focal liver lesion.

An intrahepatic gallbladder usually has impaired function because it does not empty completely. This may result in a large number of these patients to develop gallstones because of bile stasis.


References / Suggested Reading:

1. Meilstrup, JW, Hoppper KD, Thieme GA. Imaging of gallbladder variants. AJR 157:1205-1208, December 1991


Author

Shweta Bhatt, MD and Vikram S Dogra, MD

Assistant Professor (SB) and Professor (VSD) of Radiology

University of Rochester Medical Center, NY

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