Thickening of the gallbladder wall in ascites

The thickening of the gallbladder wall in patients with ascites is commonly related to hypoalbuminemia and/or portal hypertension. To evaluate the pathogenetic role of these two factors, we correlated gallbladder wall thickness (GBWT) with the albuminemia and the serum-ascites albumin gradient (SAAG), an index of portal hypertension, in 47 patients with ascites caused by cirrhosis of the liver or abdominal malignancy. We found a thickened gallbladder wall in 30/47 patients. The correlation between GBWT and SAAG was 0.64 (n = 47 p less than 0.001). No correlation was found between GBWT and albuminemia (r = 0.04). We suggest that the sonographic finding of ascites and gallbladder wall thickening should be considered a valuable sign of transudative ascites and of portal hypertension whatever its cause.