Abstract
Abdominal pain is one of the most common ailments among patients within all facets of medicine. Right upper quadrant pain and its associated pathology, such as cholecystitis and cholelithiasis, can occur in patients seeing their primary care physician, seeking care in the emergency department, and in those admitted to the intensive care unit, general floor, or long term care facilities. Ultrasound is an efficient, easy, and economical modality for a provider to evaluate the gallbladder and its surrounding structures for disease processes. This chapter will focus on performing a biliary ultrasound, basic gallbladder and biliary system anatomy, image acquisition, and interpretation of pathology.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Adeyekun AA, Ukadike IO. Sonographic evaluation of gallbladder dimensions in healthy adults in Benin City, Nigeria. West Afr J Radiol. 2013;20(1):4–8. http://www.wajradiology.org/article.asp?issn=1115-3474;year=2013;volume=20;issue=1;spage=4;epage=8;aulast=Adeyekun. Accessed 24 April 2017.
Lewiss RE, Theodoro DL. Chapter 10: hepatobiliary. In: Ma OJ, Mateer JR, Reardon RF, Joing SA, editors. Emergency ultrasound. 3rd ed. China: McGraw-Hill Education; 2014. p. 247–72.
Mohammed S, Tahir A, Ahidjo A, Mistapha Z, Franza O, Okoye I, Shugaba A. Sonographic gallbladder wall thickness in normal adult populations in Nigeria. South Afr J Radiol. 2010;14(4):84. https://www.ajol.info/index.php/sajr/article/viewFile/70566/59167. Accessed 24 April 2017.
Blackstock U, Wu S, Lewiss R, Saul T, Bagley W. Focus on: bedside biliary ultrasound. ACEP News Website. November 2010. https://www.acep.org/Content.aspx?id=64648. Accessed 24 April 2017.
Sharma S, Goyal S, Goyal RA. Prospective study to determine the effect of cholecystectomy on common bile duct diameter in Indian population. Int J Clin Exp Physiol. 2015;2(1):61–5. http://www.ijcep.org/article.asp?issn=2348-8832;year=2015;volume=2;issue=1;spage=61;epage=65;aulast=Sharma. Accessed 24 April 2017.
Datta A, Garg N, Lema PC. The significance of the wall echo shadow triad on ultrasonography: a case series. Crit Ultrasound J. 2010;2(3):107–8. http://link.springer.com/article/10.1007/s13089-010-0038-z. Accessed 24 April 2017.
Raptopoulos V, D’Orsi C, Smith E, Reuter K, Moss L, Kleinman P. Dynamic cholecystosonography of the contracted gallbladder: the double-arc-shadow sign. Am J Roentgenol. 1982;138(2):275–8. http://www.ajronline.org/doi/pdf/10.2214/ajr.138.2.275. Accessed 24 April 2017.
Brown BS, Hoffmann B, Noble VE. Chapter 45: emergency biliary ultrasonography. In: Adams JG, Barton ED, Collings J, PMC DB, Gisondi MA, Nadel ES, editors. Emergency medicine: clinical essentials. 2nd ed. Philadelphia, PA: Saunders, an imprint of Elsevier Inc.; 2013. p. 370–81.
Huffman JL, Schenker S. Acute acalculous cholecysrtitis: a review. Clin Gastroenterol Hepatol. 2010;8(1):15–22. http://www.cghjournal.org/article/S1542-3565(09)00880-5/pdf. Accessed 24 April 2017.
Smith EA, Dillman JR, Elsayes KM, Menias CO, Bude RO. Cross-sectional imaging of acute and chronic gallbladder inflammatory disease. Am J Roentgenol. 2009;192(1):188–96. http://www.ajronline.org/doi/full/10.2214/AJR.07.3803. Accessed 15 June 2017.
Author information
Authors and Affiliations
Corresponding author
Electronic Supplementary Material
Gallbladder in long axis: Gallbladder imaged in long axis (MP4 1924 kb)
Gallbladder in short axis: Gallbladder imaged in short axis (MP4 1712 kb)
Common bile duct: Common bile duct lies anterior to the thick-walled portal vein (MP4 1929 kb)
Color Doppler flow over portal triad: With color Doppler, the common bile duct will not have any flow as opposed to the surrounding vessels (MP4 1938 kb)
Large gallstone: Large gallstone with posterior acoustic shadowing (MP4 1761 kb)
Multiple gallstones: Multiple gallstones with posterior acoustic shadowing (MP4 1873 kb)
Wall echo shadow sign: Wall echo sign is seen when the gallbladder is contracted around many small stones or a single large stone (MP4 1921 kb)
Biliary sludge: Sludge appears as hyperechoic fluid layering in the dependent portions of the gallbladder, without posterior shadowing (MP4 1798 kb)
Acute cholecystitis: Gallbladder containing multiple stones and a thickened gallbladder wall suggestive of acute cholecystitis (MP4 2002 kb)
Pericholecystic fluid: Pericholecystic fluid will be visualized as anechoic or hypoechoic fluid that surrounds the gallbladder, typically secondary to inflammation (MP4 1856 kb)
Acalculous cholecystitis: Gallbladder with a thickened wall in the absence of gallstones (MP4 2273 kb)
Choledocholithiasis: A stone is visualized within the common bile duct (MP4 2686 kb)
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Creditt, A.B., Tozer, J., Joyce, M. (2018). Biliary Ultrasound. In: Clinical Ultrasound. Springer, Cham. https://doi.org/10.1007/978-3-319-68634-9_8
Download citation
DOI: https://doi.org/10.1007/978-3-319-68634-9_8
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-68633-2
Online ISBN: 978-3-319-68634-9
eBook Packages: MedicineMedicine (R0)