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22 Cards in this Set
- Front
- Back
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What is the biliary tree?
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A ductal system interconnected with GB, pancreas, and liver
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The GB is hydropic if it measures more than:
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5cm transversely and is round in shape
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Main lobar fissure connects:
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The GB to the RPV
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Phrygian Cap
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GB fundus is folded on the body, 4% pts
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Junctional Fold
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Fold anywhere in the GB wall. Can be confused with polyps and causes high amp. echoes
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Normal GB sonographically
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Anechoic/hypoechoic with walls less than 3 mm
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Courvoisier's Law/Sign
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With jaundice, an enlarged GB is unlikely due to stones, rather carcinoma of the pancreas or biliary tree.
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What is cholelithiasis?
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Gallstones
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Cholelithiasis incidence, predisposing factors, and 4 F's
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3:1 in women (increases w/ age)
Pregnancy, obesity, diabetes Fair, Fat, Fertile, Forty |
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3 types of cholelithiasis
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Cholesterol (US)
Pigment made of calcium bicarbonate Mixed stones |
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Cholelithiasis sonographically
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Prominent posterior shadow, mobile stones or sludge balls, usually move to the gravity dependent area of GB
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The Wes sign (wall, echo shadowing) or double arc, is usually present with:
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Cholelithiasis
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Diffusely dilated GB wall can be associated with:
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Acute Cholycystitis (50-75%)
Chronic Cholycystitis Inflammation Hepatic Dysfunction CHF, renal disease, AIDS Hepatitis, ascites, sepsis |
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GB wall thickening can be associated with:
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Leukemia, Chemo, GB wall varicies
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Generalized Wall Thickening
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Occurs in the postprandial (after eating)
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Focal Gallbladder Thickening
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More serious, suggests primary GB disease
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Signs of GB carcinoma
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intraluminal mass, asymmetrical wall thickening, mass replacing GB, GB wall calcification, cholelithiasis, liver mets, adenopathy, bile duct dilation
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Focal GB abnormalities may be seen with:
They corrspond to areas with: |
Metastatic melanoma, gangrenous cholycystitis
-mucosal ulceration, hemorrhages, necrosis, microabscess formations |
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Polyps can be responsible for:
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Focal GB thickening, caused by papillary adenomas, adenomyomatosis, tumefactive sludge
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Adenomyomatosis
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Small cholesterol crystals lodge within the Rokitansky-Aschoff sinuses
V-shaped reverberation |
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Sludge
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Echogenic bile or the presence of particulate material in bile.
Low level echoes Does not shadow Moves sluggishly w/ pt Can occur after fasting or with a cystic obstruction |
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Pericholecystic Fluid
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Fluid around the GB and usually seen w/ ascites. Most often attributed to acute cholecysitis, complicated by perforation and abscess formation
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