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Gas-Containing Biliary Calculi: Case Series and a Systematic Review
Sergio Huerta1,2, Rasha Kakati1, Heather Lanier2
1Department of Surgery, University of Texas Southwestern Medical School, Dallas, TX, USA.
The American Surgeon
|August 15, 2022
Summary
Gas-containing gallstones are uncommon findings in the gallbladder. These calculi are not indicative of serious pathology beyond typical gallstone complications like cholecystitis.
Area of Science:
- Gastroenterology
- Radiology
- Pathology
Background:
- Cholelithiasis (gallstones) affects many individuals, with cholecystitis occurring in 7% of cases.
- Imaging modalities like ultrasound and CT scans diagnose gallbladder disease.
- Air within the gallbladder can suggest various conditions, but gas within gallstones is not inherently pathological.
Approach:
- An institutional review of benign gallbladder disease from 2005-2021 identified patients with gas-containing gallstones.
- A PRISMA-guided literature review identified 54 additional cases of gas-containing biliary calculi.
- The study analyzed the incidence, physiology, characteristics, and clinical significance of these findings.
Key Points:
- Gas-containing biliary calculi were found in 5 of 1252 cholecystectomies.
- The literature search identified 54 unique patients with this condition.
- No patients exhibited pathology solely due to gas within the stones, only typical gallstone-related issues.
Conclusions:
- Gas-containing biliary calculi are rare findings.
- The exact mechanism of gas incorporation into gallstones remains unclear.
- These calculi should not be mistaken for free air or abscesses within the gallbladder.
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