Limited Abdomen Cholecystitis

NORMAL GALLBLADDER 

  • <4CM TRANSVERSE, <10CM LONGITUDINAL

  • ANTERIOR WALL THICKNESS <3MM 

  • COMMON BILE DUCT:

    • Measure inner wall to inner wall,

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

CHOLECYSTITIS 

  • RUQ LIMITED ABDOMEN VIEWS:

    • LONG AXIS AND SHORT AXIS CLIPS OF GB

    • CBD DIAMETER: Measure inner wall to inner wall

    • ANTERIOR GB WALL THICKNESS

    • PWD PORTAL VEIN

    • PANCREAS

    • Liver

    • MORRISON'S POUCH and right kidney 

  • TIPS

    • document (+/-) SONOGRAPHIC MURPHY'S SIGN

    • document NPO status (contracted GB will have thickened wall)

    • STONES

      • NOTE AND MEASURE All stones

      • Be sure to EVALUATE GB NECK AND CBD FOR STONES

      • LOOK FOR POSTERIOR SHADOWING

      • POLYP IS NOT MOBILE AND LESS LIKELY TO SHADOW

    • PERICHOLECYSTIC FLUID: NOTE AND DOCUMENT 

    • ANTERIOR WALL THICKNESS: NORMAL </= 3.0MM

    • COMMON BILE DUCT DIAMETER: 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

      • FREE AIR WITHIN GB WALL OR GB

Limited Abdomen Case 02 - CHolecystitis

 REFERENCES


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

PAGE AUTHORS

MATT JONES, MD

CODY MCILVAIN, MD

IMAGE CONTRIBUTORS

MATT JONES, MD