CT and clinical findings of ceftriaxone-associated gallbladder pseudolithiasis

To investigate the computed tomography (CT) and clinical findings of ceftriaxone (CTRX)‑associated gallbladder pseudolithiasis (CGPL).

The CT images and clinical data of 85 patients with a history of CTRX treatment from January 2023 to September 2023 were retrospectively analyzed.

CGPL was found in 32 of the 85 patients. CGPLs manifested as a sludge pattern in 4 patients, a nodular pattern in 9 patients, and a mud-like pattern in 19 patients. All 4 patients with existing gallbladder lithiasis were found to have CGPL after CTRX treatment. CGPL appeared on the 6th day follow-up CT at the earliest and disappeared on the 30th day follow-up CT at the earliest, CGPL completely disappeared in 12 patients. The total bilirubin level, direct bilirubin level, and albumin/globulin ratio in the patients with CGPL were significantly lower than those in the patients without CGPL; the triglyceride, β2-microglobulin level in the patients with CGPL were significantly higher than those in the patients without CGPL. The dosage and total dose of CTRX up to the first follow-up CT (TD-FFCT) in patients with CGPL were significantly higher than those in patients without CGPL.

The most common type of CGPL can be a mud-like pattern, and CGPLs can appear and disappear on the 6th and 30th day follow-up CT. The dosage and TD-FFCT are risk factors for CGPL, as well as existing gallbladder lithiasis. Total bilirubin level, direct bilirubin level, the albumin/globulin ratio, triglyceride level, β2-microglobulin level may have the evaluative value for the formation of CGPL.