Difference between revisions of "Ultrasonography of gallstones"
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[[File:Ultrasonography of a gallstone.jpg|thumb|150px]] | [[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. | *'''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]]. |
| + | {|class="wikitable" align="right" | ||
| + | |+ Common bile duct diameter in adults<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> | ||
| + | | Normal || ≤ 8 mm | ||
| + | |- | ||
| + | | Mild dilatation || 8 – 12 mm | ||
| + | |- | ||
| + | | Moderate dilatation || 12 – 16 mm | ||
| + | |- | ||
| + | | Severe dilatation || 16 – 20 mm | ||
| + | |- | ||
| + | | Extremely severe dilatation || >20 mm | ||
| + | |} | ||
| + | :*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. | ||
| + | <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. | ||
| + | </gallery> | ||
*'''Other:''' It is also proper practice to perform a {{general upper abdominal screening}}. | *'''Other:''' It is also proper practice to perform a {{general upper abdominal screening}}. | ||
{{Bottom}} | {{Bottom}} | ||
Revision as of 18:48, 11 December 2018
Author:
Mikael Häggström [notes 1]
Planning
Choice of modality
- Ultrasonography of gallstones is the investigation of choice. In suspected cholecystitis such as severe and constant pain, see Ultrasonography of cholecystitis.
How soon
- Within a couple of hours if any of the following:
- Atypical symptoms (which may indicate a more serious disease of the biliary tract or abdomen)
- Pain that does not subside on analgesics.
- Suspected pancreatitis. See: Ultrasonography of pancreatitis
- Otherwise, generally 4-8 weeks in Swedish practice.[1]
Evaluation
- 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.
| Normal | ≤ 8 mm |
| Mild dilatation | 8 – 12 mm |
| Moderate dilatation | 12 – 16 mm |
| Severe dilatation | 16 – 20 mm |
| Extremely severe dilatation | >20 mm |
- A dilated common bile duct is where it measures over 8 mm.[2] It is distinguished from the portal vein and hepatic artery by absence of flow on Doppler.
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.
- Other: It is also proper practice to perform a general upper abdominal screening.
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
References
- ↑ NU Hospital Group, Sweden
- ↑ 2.0 2.1 Yunfu Lv, Wan Yee Lau, Haiying Wu, Shunwu Chang, NingLiu, Yejuan Li, Jie Deng (2015). "Etiological Causes of Intrahepatic and Extrahepatic Bile Duct Dilatation ". International Journal of New Technology and Research (IJNTR) 1 (8). Archived from the original. .
