To assess

Pathology-specific evaluation of the gallbladder and intra- and extra-hepatic bile ducts.

 

Limitations

None

 

Patient preparation

• OUTPATIENTS: The patient should be NPO for 4-6 hours before the study, allowing for gallbladder distention and a decrease in bowel gas.

• ER/INPATIENTS: Fasting is unnecessary, given the exam's urgency. Follow-up imaging may be required if the area of interest is obscured by bowel gas, gallbladder distention is needed, etc.

 

Equipment Setup

Curvilinear array transducer with a frequency range of approximately 1-9 MHz allows appropriate penetration and resolution depending on the patient’s body habitus.

 

Common pathology

• Folds

• Phrygian cap

• Polyp

• Calculi

• Sludge

• Cholecystitis

• Adenomyomatosis

• Gallbladder Carcinoma

 

Scanning Technique

• Looking supine, Lt lateral decubitus and erect.

• Use the liver as a window, especially when rolling the patient onto their left side.

• Measure the wall <3mm.

• Is the gallbladder enlarged?>10cm in length

• Use a colour Doppler to check for enhanced vascularity of the wall.

• Examine the cystic duct, neck, body, and fundus (there may be a Phrygian cap)

 

Look for:

• Intraluminal lesions, number, size, posterior shadowing and mobility

• Wall thickness (versus degree of distension)

• Presence of mural gas or calcification

• Distension – physiological, pathological

• Point tenderness

• Pericholeic collections

 

Gall bladder size

• Length: 10 cm

• Transverse: 4 cm

• Volume: 30 – 50 ml

• Gall bladder wall: Thickness: ≤ 3 mm