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Key Image

Sonographic images of the right upper quadrant, focused on gallbladder in long and trans projections

Key Findings

Transabdominal views of gallbladder demonstrate echogenic gallstones (yellow arrow) with posterior clean shadowing (white arrow). There is gallbladder wall thickening, measuring 8 mm (red arrow). Layering tumefactive sludge is also present (blue arrow).

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Diagnosis

Acute Cholecystitis

Discussion

US evaluation is 81-100% sensitive with >92% negative and positive predictive value (NPV and PPV).

Potential findings include GB wall thickening >3 mm, hazy delineation of GB wall, gallbladder wall lucency or striated wall thickening. GB hydrops (distension with AP diameter >5 cm). Crescent-shaped loculated pericholecystic fluid. Echogenic gallstones with or without impacted stones in the GB neck.

For CT findings in this same patient, please see Case #10

For Nuclear Medicine findings in this same patient, please see Case #9

References / Resources

Additional Information:

1. Dahnert*: 713
2. Primer*:
3. Related Article:

   Bortoff, GA. "Gallbladder Stone: Imaging and Intervention." May 2000 RadioGraphics: 20, 751-766.

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