Gall Bladder Wall Thickness as a Marker of Portal Hypertension in Patients of Alcoholic Cirrhosis of Liver

Jaya Pathak1, Shivangi Gharia2, Zeal Kishor Thakkar3, Kesar Prajapati4, Darshankumar M Raval5

1Associate Professor and Head of Unit, 2,4Resident, 3,5Intern, Department of Medicine, SSG Hospital and Medical College Baroda


BACKGROUND AND OBJECTIVES: One of the major complications of cirrhosis is the occurrence of Portal Hypertension, which can lead to bleeding from Esophageal Varices, Hepatic Encephalopathy, Ascites, Spontanoeus Bacterial Peritonitis, Hepatorenal Syndrome, Hepatopulmonary Syndrome, etc. Early diagnosis and treatment of Portal hypertension is vital to prevent major complications in Cirrhosis of liver. Portal hypertension causes increase in the hydrostatic pressure causing oedema and congestion of Gallbladder also known as Congestive Cholecystopathy. In this study, we have attempted to find the correlation between presence of portal hypertension and increased diffuse Gallbladder Wall Thickness(GBWT). To study the relationship of Portal Hypertension to Diffuse Gallbladder Wall thickness on ultrasonography in patients of Alcoholic Cirrhosis of Liver, without any intrinsic Gallbladder disease. METHODS: In the present study, 60 patients of Alcoholic Cirrhosis of Liver admitted in the medical wards of SSGH, Baroda were studied. Data was collected regarding the history, physical examination, laboratory and radiological investigations, especially Gallbladder wall thickness and Upper GI Endoscopy. RESULTS: Patients were divided into 2 groups as per the Gall Bladder Wall thickness; Group A with GBWT <4mm, which consisted of 17 patients and Group B with GBWT >4mm, which consisted of 43 patients. Comparison of Serum Albumin levels between the two groups showed. CONCLUSION: In patients of Cirrhosis, increased GBWT correlated well with increased Portal Vein diameter, increased incidence of Ascites and presence of Esophageal Varices. Thus, the presence of GBWT on Ultrasonography in patients of cirrhosis without intrinsic gall bladder disease should be considered as an early sign of Portal Hypertension.

Keywords: Alcohol, Gall Bladder Wall Thickness, Cirrhosis, Portal Hypertension

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