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Increased gall bladder volume in primary sclerosing cholangitis

P C van de Meeberg¹, P Portincasa, F H Wolfhagen

¹Department of Gastroenterology, University Hospital Utrecht, The Netherlands.

|October 1, 1996

Summary

Enlarged fasting gall bladder volume is a common finding in primary sclerosing cholangitis (PSC). This non-invasive ultrasound measurement could aid in diagnosing PSC, potentially reducing the need for invasive procedures.

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Area of Science:

Hepatology
Gastroenterology
Medical Imaging

Background:

Diagnosis of primary sclerosing cholangitis (PSC) typically involves invasive methods like liver biopsy and endoscopic retrograde cholangiography (ERC).
Enlargement of the fasting gall bladder has been previously observed in PSC patients.
Gall bladder sonography offers a potential non-invasive screening approach.

Purpose of the Study:

To evaluate the utility of sonographic measurement of fasting gall bladder volume as a non-invasive diagnostic tool for PSC.
To compare fasting gall bladder volume in PSC patients with other liver conditions and healthy controls.

Main Methods:

Fasting gall bladder volume was measured using ultrasound in patients with PSC (n=24), primary biliary cirrhosis (PBC, n=13), other liver cirrhosis (n=18), ulcerative colitis (n=15), and healthy controls (n=23).
Meal-induced gall bladder emptying was assessed in PSC patients, PBC patients, and healthy controls.

Main Results:

PSC patients exhibited significantly enlarged fasting gall bladder volumes (72.9 ml) compared to healthy controls (25.4 ml), PBC patients (30.9 ml), liver cirrhosis patients (31.3 ml), and ulcerative colitis patients (25.8 ml) (p < 0.0005).
Gall bladder wall thickening (>4 mm) was noted in four PSC patients.
Postprandial gall bladder emptying was comparable across PSC patients, PBC patients, and healthy controls, suggesting normal emptying despite enlarged volume.

Conclusions:

Fasting gall bladder enlargement, in addition to wall thickening, is a frequent characteristic of PSC.
Sonographic determination of fasting gall bladder volume presents a valuable, non-invasive, and easily performed method for evaluating patients suspected of having PSC.