Gallbladder Flashcards
What percentage of patients with cholecystitis have choledochalithiasis?
15%
Patients with choledochalithiasis require what before cholecystectomy?
ERCP
What landmark goes from gallbladder to right portal vein?
Main lobar fissure
If the gallbladder is filled with stones it will appear…
echogenic line with clean shadowing
If a stone is seen in the gallbladder neck, you must scan the patient…
In two positions
In the transverse exam the gallbladder is ….. relative to the right kidney.
Anterior and medial
What is Phrygian cap with relation to gallbladders?
Fold in the fundus of the gallbladder
What are junctional folds?
Folds in gallbladder near the neck
Normal gallbladder size is
<10 cm sagittal; transverse <5cm outer wall to outer wall
Which view is more reliable for detection of gallbladder obstruction?
Transverse
Gallstones appear
Mobile (unless impacted), echogenic, and cast acoustic shadows
Gallstones in the neck require two views to evaluate…
Mobility of the stone
To see the shadowing use…
The highest frequency possible and set the focal zone around the stone
What is the primary goal of management of gallbladder polyps?
Prevention of gallbladder carcinoma
What polyp characteristics increase concern for gallbladder carcinoma?
Solitary polyp >6mm, >50 years old
What is normal gallbladder wall thickness?
<3 mm
What is adenomyomatosis?
Mucosal hyperplasia and thickening of the muscular layer of the gallbladder. Cholesterol crystals with short comet tails are produced.
Pericholecystic abscess formation is the result of …
Gallbladder wall perforation
What is the course of the common bile duct?
Inferior and medial as it approaches the duodenum
Normal common bile duct measures
Less than 7 mm from inside wall to inside wall
After cholecystectomy, the common bile duct can dilate up to
1 cm
Use the …. plane to to measure the common bile duct.
Sagittal with transducer perpendicular to costal margin toward patient’s right. CBD is anterior to portal vein
What is the WES sign?
Gallbladder so filled with stones that it is not seen except for an echogenic line with shadowing. Wall-echo-shadow
How specific for cholecystitis is the sonography Murphy’s sign?
87%
Presence of gallstones in combination with positive Murphy’s sign has a … positive predictive value for acute cholecystitis.
92%
Patient’s with acute cholecystitis must have … evaluated before surgery?
Common bile duct
How is the diagnosis of a calculus cholecystitis made?
Gallbladder dissension, intraluminal debris, and positive sonography Murphy’s
What is complicated cholecystitis?
Gangrenous cholecystitis, emphysematous cholecystitis, and perforation
Excision of gallbladder polyps is recommended when…
> 1 cm, pt older than 50, any polyp that is growing regardless if less than 1 cm
