Diagnostic Ultrasound - Abdomen and Pelvis

Approach to Biliary Sonography
Diagnoses: Biliary System
(Left) Longitudinal supine
oblique ultrasound shows an
empty gallbladder st. (Right)
Longitudinal decubitus oblique
ultrasound of the same
patient now shows small
nonshadowing stones st,
which were symptomatic.
(Left) Longitudinal decubitus
shows multiple gallbladder
stones with subtle shadowing
st. (Right) Longitudinal
decubitus ultrasound of the
same patient with harmonic
imaging shows improved
acoustic shadowing st,
increasing diagnostic
confidence.
(Left) Longitudinal decubitus
of the gallbladder shows
nondependent gas st in the
lumen, secondary to presence
of a bile duct stent. This
should be distinguished from
emphysematous cholecystitis
by demonstrating mobility and
correlating with signs of wall
inflammation. (Right)
Transverse ultrasound shows
multiple gallbladder stones
with shadowing st. The
gallbladder is distended with
sludge ſt and wall thickening
, findings indicating acute
calculous cholecystitis in the
correct clinical context.
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