Diagnostic Ultrasound - Abdomen and Pelvis

Approach to Biliary Sonography
(Left) Longitudinal oblique
ultrasound through the distal
bile duct shows a low union of
the cystic duct st and
common hepatic duct ſt.
(Right) Longitudinal oblique
decubitus ultrasound of acute
cholecystitis shows a nonmobile
stone in the
gallbladder neck st with
sludge ſt and diffuse wall
thickening . Sonographic
Murphy sign was present.
Diagnoses: Biliary System
(Left) Longitudinal oblique
decubitus ultrasound shows a
layer of stones ſt producing a
confluent shadow st. Note
the normal wall . (Right)
Longitudinal oblique decubitus
ultrasound in the same patient
shows small shadowing stones
ſt present in the dilated
common bile duct st.
(Left) Longitudinal oblique
decubitus ultrasound shows
gallbladder sludge ſt. The
sludge is less echogenic than
gallstones and nonshadowing.
Unlike polyp or mass, sludge is
not attached to the wall.
(Right) Transverse color
Doppler ultrasound shows no
color flow in sludge balls ſt.
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