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Sludge
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Sludge: thickened bile. Sludge is known as inspissated bile often seen in patients with extrahepatic biliary obstruction, acute or chronic cholecystitis, and nonfasting patients.
Songraphic Appearance: A prominent gallbladder containing low-level internal echoes that layer in the dependent portion of the gallbladder.
Image provided by: Philips
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Acute cholecystitis
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Acute cholecystitis: inflammation of the gallbladder. The patient may present with acute right upper quadrant pain which is called a positive Murphy's sign.
Songraphic Appearance: a gallbladder with an irregular outline of a thickened wall. A sonolucent area probably caused by edema has been found within the thickened wall.
This patient also demonstrates a gallstone.
Image provided by: GE
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Choledochal Cysts
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Choledochal Cysts: the results of pancreatic juices refluxing into the bile duct because of an anomalous junction of the pancreatic duct into the distal common bile duct, causing duct wall abnormality, and out pouching of the ductal walls. These cysts may be associated with gallstones, pancreatitis, or cirrhosis.
Songraphic Appearance: these cysts appear as true cysts in the right upper quadrant with or without apparent communication with the biliary system. This is an endoluminal transducer.
Image provided by: "Image/photo courtesy of the Medical University of South Carolina's Digestive Disease Center."
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Cholelithiasis
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Cholelithiasis: (Gallstones) cholesterol based calcifications within the gallbladder lumen.
Songraphic Appearance: hyperechoic foci and produce acoustic shadows. Stones are gravity dependent and will change location with patient position. This patient also demonstrates cholecystitis.
Image provided by: GE
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Choledochalithiasis
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Choledochalithiasis: cholesterol based calcifications within a bile duct.
Songraphic Appearance: echogenic foci within the extrahepatic biliary tree. Many shadow and may cause an enlarged ductal diameter.
Image provided by: Medison
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Gas in the biliary tree
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Gas in the biliary tree: gas inside of the biliary system.
Songraphic Appearance: echogenic areas within the extrahepatic ductal system that moves with dirty posterior shadowing.
Image provided by: GE
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Porcelain Gallbladder
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Porcelain Gallbladder: the gallbladder wall is calcified which can result from obstruction to the cystic duct, chronic irritation of the gallbladder wall from a stone and chronic low-grade infection or compromised circulation from an impacted cystic duct. A stone may result in hemorrhage scarring and hyalinization of the wall.
Songraphic Appearance: irregular echoes with posterior shadowing or a hyperechoic structure with shadowing in the gallbladder fossa.
Image provided by: UH RAD
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Cholangitis
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Cholangitis: infected bile.
Songraphic Appearance: the common bile duct is thickened and dilated, especially in the ampulla of Vater.
Image provided by: Ibiblio
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Cholesterolosis
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Cholesterolosis: is a condition in which cholesterol is deposited within the lamina of the gallbladder. The disease process is associated with cholesterol stones in 50% to 70% of patients. It is referred to as a “strawberry gallbladder”. Most patients do not show thickening of the gallbladder wall on imaging studies; a small percentage of patients with this condition will show cholesterol polyps; which are detected with ultrasound. The cholesterol polyp is a small structure with a single layer of epithelium and is attached to the gallbladder with a delicate stalk. These polyps are less been 10 mm in diameter.
Songraphic Appearance: cholesterol polyps are small with smooth wall projections seem to arise from the gallbladder wall. The polyps are usually multiple, do not shadow and remained fixed to the wall.
Image provided by: GE
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Adenomyomatosis
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Adenomyomatosis: papillomas on the gallbladder.
Songraphic Appearance: echogenic, non-mobile foci located singularly or in groups arising on the mucosal surface of the gallbladder.
Image provided by: GE
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Hydrops
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Hydrops: total obstruction of the cystic duct resulting in distention of the gallbladder.
Songraphic Appearance: the gallbladder is dilated with thin walls.
Image provided by: GE
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Gallbladder Carcinoma
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Gallbladder Carcinoma: gallbladder cancer.
Songraphic Appearance: large, irregular, fungating mass that contains low-level echoes within the gallbladder causing obscurity of the wall. The mass may either be heterogenous or homogenous and of an indefinite shape.
Image provided by: GE
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Gallbladder Polyps
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Gallbladder Polyps: A small tumorlike growth that projects from the gallbladder wall.
Sonographic Appearance: A hyperechoic foci in the gallbladder, that is not gravity dependent. It doesn't produce an acoustic shadow.
Image provided by: GE
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Common Bile Duct Tumor
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Common Bile Duct Tumor: Tumor in the common bile duct.
Sonographic Appearance: A hyperechoic or hypoechoic lesion in the common bile duct.
Image provided by: www.aloka.com
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