The normal gallbladder

wall thickness?

Folding back on itself at

the neck

Less than 5 cm

transverse

The normal width of the

gallbladder?

• Pain
• Nausea and vomiting
• Right shoulder pain
• chills and fever
• jaundice

Gallbladder disease

clinical findings:

Postprandial pain -

 RUQP after ingestion of greasy meal

• Fat
• Female
• Forty
• Fertile
• Flatulent

Surgical removal of the

gallbladder

• sphincter of oddi loses tone
• common bile duct takes over
• bile is free to flow into the duodenum during fasting and digestive phases
• Bile duct can be up to 1 cm

what happens when the gallbladder

 is removed?

Yes :

• During fasting state
• bedridden pts
• may fail to contract after fatty meal
• after administration of cholecystokinin

Any dilation of the gallbladder

is termed:

• a fatty meal may be administered and then rescan
• if fails to contract, scan pancreas

There could be a mass in the head of the pancreas causing obstruction

of the flow of bile

• Enlarged gallbladder
• can be palpable
• painless jaundice

Extrahepatic mass compressing

the CBD

• cholecystitis
• cholelithiasis
• adenomyomatosis
• cancer
• etc.

What can cause gallbladder wall

 thickness?

Echogenic bile often seen with

bile stasis

• Primary - stonees formed in the CBD
• Secondary - stones formed in GB, and move to CBD

Rare syndrome that causes biliary obstruction due to an impacted stone in the cystic duct

• Cause compression of the CHD
• Can cause intrahepatic biliary dilation

Most commonly caused by stones that

obstruct the flow of bile

• RUQ pain
• + murphy's sign
• fever
• leukocytosis

Sonographic signs of acute

 cholecystitis

• wall thickening
• presence of stones
• presence of stones
• hydrops
• rounding of GB

Results from numerous attacks of

acute cholecystitis, wall may become fibrotic

Gas forming bacteria invade the gallbladder wall and lumen and may also be present in the biliary ducts

• Acute inflammation of the gallbladder
• Absence of cholelithiasis
• more common in males

• Complication of acute cholecystits
• Increase in morbidity and mortality and may lead to gb perforation

• gallstones
• infection
• uncontrolled diabetes
• trauma
• malignant disease
• drug use
• atherosclerosis

• Bile ducts become infected from various disease processes including bacterial and parasitic
• Development of pus in the biliary tree

Most common pseudotumor of

the gallbladder

Condition in which cholesterol deposits from in the GB wall or mucosa, Strawberry gb

associated with diffuse polyps

• Hyperplastic change in the gallbladder wall
• Occurrs with diffuse or localized hyperplasia of the gb mucosa that extends into the muscular layer and results in outpouching or diveritcula known as Rokitansky-Aschoff sinuses
• comet tail artifact seen

• Exhibits extensive calcification of the wall
• Associated with chronic gallbladder inflammation, and nearly all pts have stones
• Increased incidence of GB carcinoma

• Tumor
• Thrombus

What is the most common causes of

 biliary obstruction?