Gallbladder Varices in Patient with HCC
Gallbladder varices are a rare form of collateralization that develops in patients with portal hypertension. We present here a case of gallbladder varices accurately diagnosed by contrast enhanced CT imaging of the abdomen (images 2 and 3) and confirmed by color Doppler sonography (image 4). A 76-year-old patient with hepatocellular carcinoma developed portal vein thrombosis secondary to tumor spread (image 1) and was incidentally discovered to have gallbladder varices. While most commonly asymptomatic, gallbladder varices are associated with increased risk of massive bleeding, either spontaneously or during cholecystectomy. As a result, the existence of such varices should be well documented if the patient is to undergo any surgical procedures. In addition, because of a particular association with portal thrombosis, patients with portal hypertension that are found to possess gallbladder varices should be evaluated for portal vein thrombosis.