Ultrasonography of gallstones - Revision history

Mikael Häggström: /* Evaluation */ More detailed

2019-03-15T11:29:27Z

Evaluation: More detailed

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2018-12-17T11:33:46Z

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2018-12-17T11:33:25Z

Evaluation: Linked away

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2018-12-11T15:48:36Z

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2018-12-06T13:47:05Z

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2018-12-06T13:20:04Z

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2018-12-06T13:15:38Z

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|author1=[[User:Mikael Häggström|Mikael Häggström]]
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==Planning==
{{Gallstones - modality}}
===How soon===
*Within a couple of hours if atypical symptoms (which may indicate a more serious disease of the [[biliary tract]] or [[abdomen]]), or if pain does not subside on analgesics.
*Otherwise, generally 4-8 weeks in Swedish practice.<ref>{{NU Hospital Group}}</ref>

==Evaluation==
[[File:Ultrasonography of a gallstone.jpg|thumb|150px]]
Gallstones are seen as hyperechoic objects, that leave an acoustic shadow. In case of similarity to a polyp ([[Ultrasonography of gallbladder polyps]]), turn the patient, making gallstones changing position, while polyps remain in the same place.

It is also proper practice to perform a {{general upper abdominal screening}}.
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@@ Line 13: / Line 13: @@
 ==Evaluation==
-[[File:Ultrasonography of a gallstone.jpg|thumb|150px]]
+[[File:Ultrasonography of sludge and gallstones, annotated.jpg|thumb|Ultrasound of biliary sludge, gallstones and borderline thickening of the gallbladder wall (3 mm).]]
 *'''Gallbladder''': Gallstones are seen as hyperechoic objects, that leave an acoustic shadow. In case of similarity to a polyp ([[Ultrasonography of gallbladder polyps]]), turn the patient, making gallstones changing position, while polyps remain in the same place.
-*'''Related structures''': Also exclude signs of cholecystitis, mainly pericholecystic fluid, gallbladder wall thickening, dilation of the bile duct (see below), and a sonographic Murphy's sign. Further information: [[Ultrasonography of cholecystitis]].
+*'''Related structures''': Also exclude signs of cholecystitis, mainly pericholecystic fluid, edematous pericholecystic fat, gallbladder wall thickening, dilation of the bile duct (see below), and a sonographic Murphy's sign. Further information: [[Ultrasonography of cholecystitis]].
 :*A '''dilated common bile duct''' is where it measures over 8 mm.<ref name=Lv>{{cite journal|url=https://www.ijntr.org/download_data/IJNTR01080032.pdf|title=Etiological Causes of Intrahepatic and Extrahepatic Bile Duct Dilatation|author=Yunfu Lv, Wan Yee Lau, Haiying Wu, Shunwu Chang, NingLiu, Yejuan Li, Jie Deng|journal=International Journal of New Technology and Research (IJNTR)|volume=1|issue=8|year=2015}}</ref> It is distinguished from the portal vein and hepatic artery by absence of flow on Doppler. ''Further information: '''[[Ultrasonography of dilated bile ducts]]'''
 <gallery heights=230 widths=230>

@@ Line 16: / Line 16: @@
 *'''Gallbladder''': Gallstones are seen as hyperechoic objects, that leave an acoustic shadow. In case of similarity to a polyp ([[Ultrasonography of gallbladder polyps]]), turn the patient, making gallstones changing position, while polyps remain in the same place.
 *'''Related structures''': Also exclude signs of cholecystitis, mainly pericholecystic fluid, gallbladder wall thickening, dilation of the bile duct (see below), and a sonographic Murphy's sign. Further information: [[Ultrasonography of cholecystitis]].
-:*A '''dilated common bile duct''' is where it measures over 8 mm.<ref name=Lv/> It is distinguished from the portal vein and hepatic artery by absence of flow on Doppler. ''Further information: '''[[Ultrasonography of dilated bile ducts]]'''
+:*A '''dilated common bile duct''' is where it measures over 8 mm.<ref name=Lv>{{cite journal|url=https://www.ijntr.org/download_data/IJNTR01080032.pdf|title=Etiological Causes of Intrahepatic and Extrahepatic Bile Duct Dilatation|author=Yunfu Lv, Wan Yee Lau, Haiying Wu, Shunwu Chang, NingLiu, Yejuan Li, Jie Deng|journal=International Journal of New Technology and Research (IJNTR)|volume=1|issue=8|year=2015}}</ref> It is distinguished from the portal vein and hepatic artery by absence of flow on Doppler. ''Further information: '''[[Ultrasonography of dilated bile ducts]]'''
 <gallery heights=230 widths=230>
 File:Ultrasonography of common bile duct stone, with arrow.jpg|In case of a dilated bile duct, an attempt can be made to follow it to detect visible gallstones therein, such as in this case.

@@ Line 16: / Line 16: @@
 *'''Gallbladder''': Gallstones are seen as hyperechoic objects, that leave an acoustic shadow. In case of similarity to a polyp ([[Ultrasonography of gallbladder polyps]]), turn the patient, making gallstones changing position, while polyps remain in the same place.
 *'''Related structures''': Also exclude signs of cholecystitis, mainly pericholecystic fluid, gallbladder wall thickening, dilation of the bile duct (see below), and a sonographic Murphy's sign. Further information: [[Ultrasonography of cholecystitis]].
-{|class="wikitable" align="right"
+:*A '''dilated common bile duct''' is where it measures over 8 mm.<ref name=Lv/> It is distinguished from the portal vein and hepatic artery by absence of flow on Doppler. ''Further information: '''[[Ultrasonography of dilated bile ducts]]'''
 <gallery heights=230 widths=230>
 File:Ultrasonography of common bile duct stone, with arrow.jpg|In case of a dilated bile duct, an attempt can be made to follow it to detect visible gallstones therein, such as in this case.

@@ Line 15: / Line 15: @@
 [[File:Ultrasonography of a gallstone.jpg|thumb|150px]]
 *'''Gallbladder''': Gallstones are seen as hyperechoic objects, that leave an acoustic shadow. In case of similarity to a polyp ([[Ultrasonography of gallbladder polyps]]), turn the patient, making gallstones changing position, while polyps remain in the same place.
-*'''Related structures''': Also exclude signs of cholecystitis, mainly pericholecystic fluid, gallbladder wall thickening, dilation of the bile duct, and a sonographic Murphy's sign. Further information: [[Ultrasonography of cholecystitis]].
+*'''Related structures''': Also exclude signs of cholecystitis, mainly pericholecystic fluid, gallbladder wall thickening, dilation of the bile duct (see below), and a sonographic Murphy's sign. Further information: [[Ultrasonography of cholecystitis]].
 *'''Other:''' It is also proper practice to perform a {{general upper abdominal screening}}.
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