Gallbladder Wall Thickening Misinterpretation

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Questions and Answers

What imaging techniques are used to evaluate gallbladder disease?

Sonography, CT, and MRI

What is the normal gallbladder wall thickness on sonography?

Less than 1 mm

What can cause thickening of the gallbladder wall?

Acute cholecystitis and chronic renal insufficiency

Which imaging technique is often used as the first imaging technique in patients with an acute abdomen?

CT Signup and view all the answers

How can liver abscesses, infected cysts, and amoebic abscesses be differentiated?

By their hypochogenic masses with strong back walls, irregular outline, and internal debris Signup and view all the answers

Why is knowledge of gallbladder wall thickness differential diagnosis essential?

To avoid unnecessary cholecystectomies or delayed treatment Signup and view all the answers

What may cause a predominantly echo-free, sharply delineated, crescentic area between the liver and the right hemidiaphragm?

A right-sided subphrenic abscess Signup and view all the answers

How can subcapsular haematomas present on ultrasound?

As an echo-free or complex area located between the capsule of the liver and the underlying liver parenchyma Signup and view all the answers

What should be examined when using ultrasound to search for the cause of pyrexia of unknown origin?

Both left and right subphrenic regions Signup and view all the answers

What can reliably detect intrahepatic haematomas?

Ultrasound Signup and view all the answers

Which maneuver is important for both screening for pancreatic carcinoma and follow-up of high-risk individuals?

Right lateral decubitus Signup and view all the answers

What is an important ultrasound finding in high-risk individuals for pancreatic carcinoma?

Main pancreatic duct (MPD) dilatation Signup and view all the answers

What can improve the visualization of the tail of the pancreas during ultrasound?

Liquid-filled stomach method Signup and view all the answers

What may cause diffuse enlargement of the pancreas and elevated serum amylase?

Acute pancreatitis Signup and view all the answers

How do true pancreatic cysts appear on ultrasound?

$Smooth$, echo-free cavities filled with fluid Signup and view all the answers

What is the preferred method for evaluating suspected biliary diseases?

Ultrasound Signup and view all the answers

How does the gallbladder appear on a longitudinal ultrasound scan?

Echo-free, pear-shaped Signup and view all the answers

What is the normal width of the gallbladder?

Seldom more than 4 cm Signup and view all the answers

Where is the common hepatic duct usually recognizable on ultrasound?

Near the crossing portal vein Signup and view all the answers

What is a potential indication for gallbladder and biliary tract scanning?

Pain in the right upper abdomen Signup and view all the answers

What can cause a distended gallbladder?

Dehydration, low-fat diet, intravenous nutrition, or immobilization Signup and view all the answers

What are common causes of nonmobile internal echoes in the gallbladder?

Calculi, gallbladder sludge, pyogenic debris, hydatid membranes, and parasites Signup and view all the answers

What is associated with acute cholecystitis?

Pain in the right upper abdomen, local tenderness, and thickened and edematous gallbladder walls Signup and view all the answers

How can a distended gallbladder be diagnosed?

A fatty meal and ultrasound examination Signup and view all the answers

What can indicate the presence of gallstones in the gallbladder?

$ ext{Mobile internal echoes with shadowing}$ Signup and view all the answers

What is the preferred imaging method for assessing pancreatic calcification?

X-ray of the upper abdomen Signup and view all the answers

What can calcification within the pancreas produce on ultrasound?

Bright discrete echoes without shadowing Signup and view all the answers

What is a common cause of calcification in the pancreas?

Biliary calculi in the distal common bile duct Signup and view all the answers

What is the normal maximum internal diameter of the pancreatic duct?

$2$ mm Signup and view all the answers

What condition is usually associated with jaundice and dilatation of the biliary tract?

$\text{Tumour of the head of the pancreas}$ Signup and view all the answers

Study Notes

The gallbladder is a small, pear-shaped organ that stores bile, which helps break down fats. When it becomes enlarged (distended), it may not function properly.
A distended gallbladder may exceed 4 cm in width and can be caused by dehydration, low-fat diet, intravenous nutrition, or immobilization.
A fatty meal and ultrasound examination can be used to diagnose a distended gallbladder. A normal gallbladder will contract after consumption of a fatty meal.
Causes of a distended gallbladder with thickened walls and filled with fluid include empyema (local tenderness is likely) and mucocele (no local tenderness).
Acute cholecystitis is associated with pain in the right upper abdomen, local tenderness, and thickened and edematous gallbladder walls. It may also result in a perforated gallbladder with fluid adjacent to it.
Mobile internal echoes with shadowing can indicate gallstones. Stones may be single or multiple, large or small, calcified or non-calcified.
Nonmobile internal echoes without shadowing can indicate a polyp. Malignant disease may also resemble a polyp but is more often associated with thickening of the gallbladder wall and does not have a pedicle.
Ultrasound scans should be taken in different positions to accurately diagnose gallbladder conditions. Common causes of nonmobile internal echoes include calculi, gallbladder sludge, pyogenic debris, hydatid membranes, and parasites.
Thickening of the gallbladder wall is a common finding on diagnostic imaging studies and is associated with primary gallbladder disease and acute cholecystitis.
A fatty meal and ultrasound examination can be used to diagnose a distended gallbladder. If there is no contraction, search for a gallstone or other cause of obstruction within the cystic duct.

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