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CASE REPORT
Year : 2018  |  Volume : 26  |  Issue : 2  |  Page : 103-106

Tumefactive sludge mimicking gallbladder neoplasm: A case report and review of the literature


1 Department of Internal Medicine, Division of Gastroenterology, Cheng Ching General Hospital, Taichung, Taiwan
2 Department of Surgery, Cheng Ching General Hospital, Taichung, Taiwan

Correspondence Address:
Dr. Cheng-Chi Lee
Department of Internal Medicine, Division of Gastroenterology, Cheng Ching General Hospital, No. 966, Sec. 4, Taiwan Blvd, Xitun District, Taichung City 40764
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JMU.JMU_19_18

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Biliary sludge (or very thick bile) is mainly comprised of calcium bilirubinate granules and lesser amounts of cholesterol crystals, and it can produce a layer of low amplitude of echoes in the most dependent part of the gallbladder (GB). In tumefactive biliary sludge, low-amplitude echoes do not form a fluid–fluid level but instead tend to give the appearance of a polypoid mass that is bounded by a smooth margin, round, and lobulated. Differential diagnoses for an echogenic mass in the GB lumen include GB carcinoma, tumefactive sludge, and gangrenous cholecystitis. In this case report, we describe a rare case in which biliary sludge did not form a fluid–fluid level but tended to accumulate and appear as a polypoid mass within the lumen of the GB. The lesion was finally identified as being tumefactive sludge mimicking neoplasm of the GB.


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