A plain abdominal radiograph of a 58-year-old woman with recurrent right hypochondrial pain shows a rim of curvilinear calcification outlining the gallbladder wall. Which complication is this finding classically associated with?

• A Gallstone ileus
• B Porcelain gallbladder causing pancreatitis
• C Carcinoma of the gallbladder ✓
• D Xanthogranulomatous cholecystitis with fistula formation

Explanation

The radiograph shows porcelain gallbladder, extensive dystrophic calcification of the chronically inflamed wall. It is classically linked to an increased incidence of gallbladder carcinoma, so cholecystectomy is advised even when asymptomatic. Gallstone ileus follows erosion of a large stone into the duodenum and shows pneumobilia, not wall calcification. Xanthogranulomatous cholecystitis mimics malignancy on imaging but is not caused by a calcified wall.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.