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Joseph Junewick, MD FACR
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Gallbladder varices

Case Detail

Anatomy: Gastrointestinal
Betz
Bradford W. Betz, MD
Diagnostic Category: Vascular
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: US
Activities:
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History

8 year-old girl with splenomegaly was evaluated with ultrasound


Case Images


Diagnosis

Gallbladder varices secondary to portal vein thrombosis

Findings

Numerous anechoic areas in the gallbladder wall have venous flow by color Doppler ultrasound, consistent with gallbladder varices.

Cavernous transformation of the portal vein was also present (images not included here).

Discussion

Gallbladder varices are a portosystemic shunt between the cystic vein branch of the portal vein and either the systemic veins of the anterior abdominal wall or patent intrahepatic portal vein branches. They are more frequently observed with portal vein thrombosis than with other causes of portal hypertension, occurring in 25-60% children with this diagnosis. Gallbladder varices are usually asymptomatic but can affect gallbladder contractility and are a rare cause of hemobilia.

The presence of gallbladder varices on an imaging study should prompt a search for portal vein thrombosis or other causes of portal hypertension.

Reference

Yamada RM, Hessel G. Ultrasonographic assessment of the gallbladder in 21 children with portal vein thrombosis. Pediatr Radiol 2005; 35: 290-294

Chawla Y, Dilawari JB, Katariya S. Gallbladder varices in portal vein thrombosis. AJR 1994; 162: 643-645

Contributor

Daniel H. Betz



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