Sonography of thickened gallbladder wall: causes in children

A review of 793 consecutive abdominal sonograms in children aged 1 day to 16 years disclosed 453 patients in whom the gallbladder was clearly visible on at least two perpendicular views. Twenty had a gallbladder wall more than 3 mm thick. The following diseases were associated with gallbladder wall thickening; hypoalbuminemia (13 cases), ascites (five, three with concomitant hypoalbuminemia), physiologic thickening because of partial wall contraction (one), and systemic venous hypertension (one). None of 26 patients with gallstones and one of 14 with sludge had a thickened gallbladder. (The latter patient had concomitant hypoalbuminemia). Five patients with surgically proven acute cholecystitis during this same interval of time had sonograms. In four, the gallbladder wall was of normal thickness. In the fifth patient, the gallbladder wall could not be visualized because of densely shadowing stones. In this population, thickening of the gallbladder wall was not associated with acute cholecystitis and thus was not an indication for cholecystectomy.