Gallbladder Wall Thickening Quiz

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Questions and Answers

What is a characteristic feature of liver abscesses according to the text?

Hypochogenic masses with strong back walls (correct)

Hypoechoic masses with smooth back walls

Hyperechogenic masses with irregular outline

Hyperechoic masses with internal gas

How can subphrenic abscesses be identified using ultrasound?

An echo-free area located between the capsule of the liver and the underlying liver parenchyma

A hyperechoic mass with smooth outline near the liver parenchyma

A predominantly echo-free, sharply delineated, crescentic area between the liver and the right hemidiaphragm (correct)

A hypoechoic mass with irregular outline within the liver

What may be needed to differentiate haematomas from abscesses in the liver?

Clinical history and symptoms (correct)

Surgical exploration

Blood tests only

Ultrasound imaging only

Where can subcapsular haematomas be located in the liver?

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 is a common cause of a distended gallbladder?

Dehydration Signup and view all the answers

How can a distended gallbladder be diagnosed?

Fatty meal and ultrasound examination Signup and view all the answers

What can nonmobile internal echoes without shadowing indicate?

Polyp Signup and view all the answers

What is associated with acute cholecystitis?

Pain in the right upper abdomen and thickened gallbladder walls Signup and view all the answers

What should be searched for if there is no contraction of the gallbladder after a fatty meal?

Gallstone or other cause of obstruction within the cystic duct Signup and view all the answers

What is the preferred imaging method for assessing pancreatic calcification?

Supine anteroposterior radiograph 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

What is the preferred method for evaluating suspected biliary diseases?

Ultrasound Signup and view all the answers

How wide is the normal gallbladder, according to the text?

Less than 4 cm Signup and view all the answers

Where is the common hepatic duct usually recognizable?

Near the crossing portal vein Signup and view all the answers

What are indications for gallbladder and biliary tract scanning?

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

What is the maximum common bile duct diameter near its entrance into the pancreas?

$5 mm$ Signup and view all the answers

What imaging techniques are used to evaluate gallbladder disease?

Sonography, CT, and MRI Signup and view all the answers

What is the normal gallbladder wall thickness on sonography?

$< 2$ mm Signup and view all the answers

What conditions can lead to gallbladder wall thickening?

Cholecystitis and congestive cardiac failure Signup and view all the answers

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

CT Signup and view all the answers

Why is careful clinical correlation needed for gallbladder wall thickness between 3 and 5 mm?

To make accurate diagnoses Signup and view all the answers

What is the main pancreatic duct (MPD) dilatation threshold for important ultrasound findings in high-risk individuals (HRIs)?

3 mm or more Signup and view all the answers

Which scanning maneuvers are important for both screening for PC and follow-up of HRIs?

Right lateral decubitus, sitting, and upright positions Signup and view all the answers

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

Liquid-filled stomach method Signup and view all the answers

What do true pancreatic cysts appear as in ultrasound?

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

What may cause diffuse enlargement of the pancreas in ultrasound, associated with elevated serum amylase and local ileus?

Acute pancreatitis Signup and view all the answers

Study Notes

Ultrasound (US) is used widely for mass screening due to its simplicity and non-invasiveness, but visualizing the entire pancreas can be difficult due to its complicated anatomy, obesity, and gas
US plays a crucial role in the diagnosis of pancreatic carcinoma (PC) with main pancreatic duct (MPD) dilatation (3 mm or more) and pancreatic cysts (5 mm or larger) being important US findings in high-risk individuals (HRIs), who should be monitored periodically
Scanning maneuvers, such as right lateral decubitus, sitting, and upright positions, are important for both screening for PC and follow-up of HRIs
US can be challenging to visualize the tail of the pancreas due to gas and stool, and poor visualization can be improved by the liquid-filled stomach method
Normal pancreas has the same echogenicity as the adjacent liver and appears homogeneous; certain anatomical landmarks should be identified during scanning including the aorta, inferior vena cava, superior mesenteric artery, splenic vein, and superior mesenteric vein
Pancreatic size and shape vary widely; a small, non-homogeneous pancreas may be due to chronic pancreatitis or a tumor
Acute pancreatitis can cause diffuse enlargement of the pancreas, which may be normal or hypochogenic compared with the liver, and is associated with elevated serum amylase and local ileus
Focal enlargement (noncystic) of the pancreas cannot be distinguished from focal pancreatitis or pancreatic tumor by US alone, and a biopsy may be necessary if the pattern is mixed
True pancreatic cysts are rare and appear as smooth, echo-free cavities filled with fluid; pseudocysts following trauma or acute pancreatitis are not uncommon and can be complex in the early stages with ill-defined walls and internal echoes, but eventually become smooth-walled and echo-free.

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Description

Test your knowledge about the diagnostic challenges associated with diffuse gallbladder wall thickening in patients with and without intrinsic gallbladder disease. Explore the potential misinterpretations and implications of this imaging finding.