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Chapter 7
Gallbladder and the Biliary System
59
Anatomy
08/31/2011

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Term
Small polypoid projections from the gallbladder wall
Definition
Adenomyomatosis
Term
Small opening in the duodenum in which the pancreatic and common bile duct enter to release secretions
Definition
Ampulla of Vater
Term
Yellow pigment in the bile formed by the breakdown of red blood cells
Definition
Bilirubin
Term
Inflammation of the bile duct
Definition
Cholangitis
Term
Removal of the gallbladder
Definition
Cholecystectomy
Term
Inflammation of the gallbladder; may be acute or chronic
Definition
Cholecystitis
Term
Hormone secreted into the body by the mucosa of the upper small intestine; stimulates contraction of the gallbladder and pancreatic secretion of enzymes
Definition
Cholecystokinin
Term
Dilation of the common duct that may cause obstruction
Definition
Choledochal cyst
Term
Stones in the bile duct
Definition
Choledocholithiasis
Term
Gallstones in the gallbladder
Definition
Cholelithiasis
Term
Variant of adenomyomatosis; cholesterol polyps
Definition
Cholesterosis
Term
Extends from the point where the common hepatic duct meets the cystic duct; drains into the duodenum after it joins with the main pancreatic duct
Definition
Common Bile Duct
Term
Refers to common bile or hepatic ducts when cystic duct is not seet
Definition
Common Duct
Term
Bile duct system that drains the liver into the common bile duct
Definition
Common Hepatic Duct
Term
Connects the gallbladder to the common hepatic duct
Definition
Cystic Duct
Term
Storage pouch for bile
Definition
gallbladder
Term
Small part of the gallbladder that lies near the cystic duct where stones may collect
Definition
Hartmann's pouch
Term
Tiny valves found within the cystic duct
Definition
Heister's valve
Term
Massive enlargement of the gallbladder
Definition
Hydrops
Term
excessive bilirubin accumulation causes yellow pigmentation of the skin; first seen in the whites of the eyes
Definition
Jaundice
Term
Small septum within the gallbladder, usually arising from the posterior wall
Definition
Junctional Fold
Term
Cancer at the biforcation of the hepatic ducts; may cause asymmetric obstruction of the biliary tree
Definition
Klatskin's tumor
Term
Travels horizontally through the pancreas to join the common bile duct at the amulla of vater
Definition
Pancreatic duct
Term
Gallbladder variant in which part of the fundus is vent back on itself
Definition
Phrygian cap
Term
Small, well defined soft tissue projectio from the gallbladder wall
Definition
Polyp
Term
Calcification of the gallbladder wall
Definition
Porcelain Gallbladder
Term
Central area of the liver where the portal vein, common, and hepatic artery enter
Definition
Porta Hepatis
Term
Low-level echoes found along the posterior margin of the gallbladder; move with changes in position
Definition
Sludge
Term
Small muschle that guards the ampulla of vater
Definition
Sphincter of Oddi
Term
Sonographic patter found when the gallbladder is packed with stones
Definition
WES - wall echo shadow sign
Term
How big in diameter is the common hepatic duct?
Definition
4mm
Term
How big in diameter is the common bile duct?
Definition
6mm
Term
How big in diameter is the cystic duct?
Definition
4cm
Term
Where is the GB located?
Definition
URQ, close to visceral surface of the liver
Term
What size is the GB usually?
Definition
2.5-4cm wide
7-10cm long
3mm thick
Term
What happens to the GB when the stomach is emptied?
Definition
duodenal peristalsis diminishes
gb relaxes
sphincter of oddi opens
Term
The common hepatic duct is joined by the cystic duct to form the ?
Definition
Common Bile Duct
Term
The CBD is joined by the main pancreatic duct, and together they open through a small _______________ into the duodenal wall?
Definition
amupulla of vater
Term
The arterial supply of the GB is from the _______________ artery, which is a branch of the right hepatic artery?
Definition
Cystic artery
Term
What are the 2 primary functions of the extrahepatic biliary tract?
Definition
1.To transport bile from the liver to the intestines
2.Regulation of it's flow
Term
Bile is the principle medium for excretion of bilirubin and ____________?
Definition
Cholesterol
Term
The _______ from the small intestines stimulate the liver to make more bile. This activates intestinal and pancreatic enzymes.
Definition
Bile salts
Term
The sign that indicates an extrahepatic mass compressing the common bile duct, which can produce an enlarged gallbladder, is called?
Definition
Courvoisier's sign
Term
Sonographically, the CBD lies?
Definition
Anterior and to the right of the portal vien
Term
The hepatic artery lies?
Definition
Anterior and to the left of the portal vien
Term
On sagittal scans, the right branch of the hepatic artery usually passes __________ to the common duct?
Definition
Posterior
Term
The common duct is seen just _________ to the portal vein before it dips posteriorly to enter the head of the pancreas?
Definition
Anterior
Term
what are the sonographic findings for sludge?
Definition
low level echoes layering in dependant part of GB.
Looks like sand
Changes with patient position
Term
What are the sonographic findings for Acute Cholecystitis?
Definition
Dialation and rounding of GB
+ Murphy sign
Thick GB wall
stones
Term
Sonographic signs for Chronic Cholecystitis?
Definition
Contraction of GB
Stones
WES sign
Term
Sonographic signs for Acalculous Choleystitis?
Definition
Dialation of GB
+ Murphy sign
Thick GB wall
Edema
Sludge
Term
Sonographic findings for Emphysematous Cholocystitis?
Definition
Bright echo in area of GB with ring down/comet tail.
May appear as WES
Term
Sonographic findings for Gangrenous Cholecystitis?
Definition
Medium to course echogenics
No shadow
No gravity dependent
No layering
Term
Sonographic findings for Cholelithiasis?
Definition
Dialated GB
Thick walls
Hyperechoic intraluminal echoes
WES sign
Gravity dependent calcifications in GB
Term
Sonographic findings for Choledochal Cysts?
Definition
Localized dialated cystic CBD
Diverticulum of CBD
Invagination of CBD
Dialated CBD and CHD
Term
Songraphic findings for Adenoma of the GB
Definition
near fundus
No change with position
No shadow produced
Term
Sonographic findings for Adenomyomatosis of the GB?
Definition
Papillomas may occur
No change with position
"Comet tail" artifact
Term
Sonographic findings for Porcelain GB?
Definition
GB wall thick, calcified with shadowing
Term
Sonographic findings for Choledocholithiasis?
Definition
Echogenic structures in extrahepatic duct
Dialated biliary tree