Page Authors

MATT JONES, MD, MS, RDMS, RDCS

CODY MCILVAIN, MD CANDIDATE CLASS OF 2020

 

Consulting Specialists

A. KYLE DEAL, MD (INTERVENTIONAL RADIOLOGY)

 

Image Contributors

MATT JONES, MD, MS, RDMS, RDCS

 

Limited Abdomen - Cholecystitis

 

Basics

Normal Gallbladder 

  • <4cm transverse, <10cm longitudinal

  • Anterior wall thickness <3mm 

  • COMMON BILE DUCT: NORMAL </= 6.0MM UP TO AGE 60, THEN ADDITIONAL MM PER DECADE (70YO = 7.0MM, 80YO = 8.0MM...)

Cholecystitis 

  • Sonographic murphy's sign

  • Views: Long axis and short axis clips of GB, CBD measurement, anterior GB wall thickness, Morrison's pouch.  

  • Be sure to visualize GB neck.

  • stones: note and measure (look for posterior shadowing)

  • pericholecystic fluid 

  • Anterior wall thickness: normal </= 3.0mm

  • Common bile duct: normal </= 6.0mm up to age 60, then additional mm per decade (70yo = 7.0mm, 80yo = 8.0mm...) 

  • advanced cholecystitis: look for SLOUGHED MUCOSAL MEMBRANES, WALL DISRUPTION, WALL ULCERATION, FOCAL WALL BULGE

 

Examples

 

 

 

Useful Links to Review

 

 

References


Middleton, William D., Alfred B. Kurtz, and Barbara S. Hertzberg. Ultrasound: the requisites. 2nd edition. St. Louis, MO: Mosby, 2004.