GAMUT G-128
GAS IN THE GALLBLADDER OR BILIARY TRACT


COMMON
1. Biliary-enteric fistula  to duodenum or colon (eg, perforated ulcer or adenocarcinoma of duodenum, ampulla, bile duct, gallbladder, stomach, pancreas, or colon; metastasis; lymphoma G) (See G-139)
2. Cholecystitis with perforation
3. Emphysematous cholecystitis , cholangitis (esp. in diabetic)
4. [Gas in portal vein]
5. Postoperative  (eg, sphincterotomy; biliary-intestinal anastomosis {cholecystoenterostomy; choledochoenterostomy; Whipple procedure}; internal or external biliary drainage)
6. Recent passage of gallstone from gallbladder or common duct (eg, gallstone ileus)


UNCOMMON
1. Common duct entry into duodenal diverticulum
2. Crohn's disease
3. [Gas in gallstone]
4. [Normal periductal fat]
5. Pancreatitis
6. Parasitic disease (clonorchiasis; ascariasis; ruptured amebic abscess of liver; strongyloidiasis  of duodenum)
7. Peptic ulcer with perforation into common duct and fistula
8. Physiologic (incompetent, patulous sphincter, esp. in elderly)
9. Postbulbar duodenal ulcer adjacent to ampulla with spasm (acute) or fibrosis (healing)
10. Trauma, external penetrating or iatrogenic (eg, intubation; ERCP)


[    ] This condition does not actually cause the gamuted imaging finding, but can produce imaging changes that simulate it.




References