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22 Cards in this Set

  • Front
  • Back
What is the biliary tree?
A ductal system interconnected with GB, pancreas, and liver
The GB is hydropic if it measures more than:
5cm transversely and is round in shape
Main lobar fissure connects:
The GB to the RPV
Phrygian Cap
GB fundus is folded on the body, 4% pts
Junctional Fold
Fold anywhere in the GB wall. Can be confused with polyps and causes high amp. echoes
Normal GB sonographically
Anechoic/hypoechoic with walls less than 3 mm
Courvoisier's Law/Sign
With jaundice, an enlarged GB is unlikely due to stones, rather carcinoma of the pancreas or biliary tree.
What is cholelithiasis?
Cholelithiasis incidence, predisposing factors, and 4 F's
3:1 in women (increases w/ age)
Pregnancy, obesity, diabetes
Fair, Fat, Fertile, Forty
3 types of cholelithiasis
Cholesterol (US)
Pigment made of calcium bicarbonate
Mixed stones
Cholelithiasis sonographically
Prominent posterior shadow, mobile stones or sludge balls, usually move to the gravity dependent area of GB
The Wes sign (wall, echo shadowing) or double arc, is usually present with:
Diffusely dilated GB wall can be associated with:
Acute Cholycystitis (50-75%)
Chronic Cholycystitis
Hepatic Dysfunction
CHF, renal disease, AIDS
Hepatitis, ascites, sepsis
GB wall thickening can be associated with:
Leukemia, Chemo, GB wall varicies
Generalized Wall Thickening
Occurs in the postprandial (after eating)
Focal Gallbladder Thickening
More serious, suggests primary GB disease
Signs of GB carcinoma
intraluminal mass, asymmetrical wall thickening, mass replacing GB, GB wall calcification, cholelithiasis, liver mets, adenopathy, bile duct dilation
Focal GB abnormalities may be seen with:
They corrspond to areas with:
Metastatic melanoma, gangrenous cholycystitis
-mucosal ulceration, hemorrhages, necrosis, microabscess formations
Polyps can be responsible for:
Focal GB thickening, caused by papillary adenomas, adenomyomatosis, tumefactive sludge
Small cholesterol crystals lodge within the Rokitansky-Aschoff sinuses
V-shaped reverberation
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
Pericholecystic Fluid
Fluid around the GB and usually seen w/ ascites. Most often attributed to acute cholecysitis, complicated by perforation and abscess formation