We previously analysed 22 cases of patients who underwent abdominal paracentesis and suggested that thickened gallbladder wall thickness is associated with non-malignant aetiology [1]. This is a retrospective review seeking to confirm the findings of the relationship between gallbladder wall thickness and the aetiology of ascites. Ultrasound abdomen and paracentesis are routinely suggested to further evaluate the aetiology of ascites, however due to the low sensitivity of cytology results [2,3], the underlying pathology is often not confidently identified. We hypothesise that in combination with non-invasive...

In this cross-sectional analytical study, we included all patients who presented to The Tweed Hospital in a 5-year period (March 2016 to March 2021) whom had a dedicated ultrasound of the gallbladder. Ultrasound was performed in all individuals by the same sonographer to eliminate the operator dependent factor, before subsequently undergoing abdominal paracentesis. Patients with concurrent gallbladder pathology including cholelithiasis, gallbladder sludge and adenomyomatosis were excluded. Baseline characteristics of patients were obtained via electronic medical records, consisted of patient’s demographics, cytology results, medical history, and...

34 patients were identified as eligible in the 5-year period. 15 (44%) patients having a histopathological diagnosis of malignancy and 19 (56%) patients with negative histopathological and cytological results. In the group with non-malignant aetiology ascites, 14 of them had chronic liver disease, 4 of them had chronic kidney disease and 1 patient had concurrent chronic liver and kidney disease. In patients with non-malignant ascites(Mean: 4.8mm, 95% CI 3.8-5.8mm), their gallbladder wall was significantly thicker than patients with malignant ascite(Mean: 2.8mm, 95% CI 2.2 -3.3mm)....

This study suggests that there is a strong association between gallbladder wall thickness and aetiology of ascites. We hypothesis that chronic kidney and liver disease have resulted in fluid third spacing and leading to gallbladder wall oedema. In contrast, malignant ascites more likely results from peritoneal metastasis. Routine measurement of gallbladder wall thickness during paracentesis is a useful tool in predicting the aetiology of ascites. Normal gallbladder wall thickness with ascites is a strong predictor factor of an underlying malignancy. Despite a negative cytology result...

1. Sparreboom B, Litton B, Englebrecht V. Using Sonographic Gallbladder Wall Thickness to Differentiate Benign from Malignant Causes of Ascites. European Congress of Radiology-2016 ASM. 2. Jha R, Shrestha HG, Sayami G, Pradhan SB. Study of effusion cytology in patients with simultaneous malignancy and ascites. Kathmandu University medical journal (KUMJ). 2006 Oct 1;4(4):483-7. 3. Karoo RO, Lloyd TD, Garcea G, Redway HD, Robertson GS. How valuable is ascitic cytology in the detection and management of malignancy?. Postgraduate medical journal. 2003 May 1;79(931):292-4.