Difference between revisions of "Ultrasonography of gallstones"
Jump to navigation
Jump to search
(Expanded) |
(→Evaluation: Linked away) |
||
| 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. | *'''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, 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/> It is distinguished from the portal vein and hepatic artery by absence of flow on Doppler. | ||
<gallery heights=230 widths=230> | <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. | 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. | ||
Revision as of 14:33, 17 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.
- 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. Further information: Ultrasonography of dilated bile ducts
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
- ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedLv
