Diagnostic Ultrasound - Abdomen and Pelvis

Choledocholithiasis
(Left) A single echogenic focus
ſt with dense posterior
acoustic shadowing
compatible with a stone is
seen in the CBD on this
longitudinal ultrasound. The
CBD is mildly dilated, likely
secondary to obstruction from
the stone. (Right) Transverse
oblique ultrasound in the same
patient confirms the calculus
ſt within the common bile
duct . There is shadowing
noted posteriorly.
Diagnoses: Biliary System
(Left) Longitudinal ultrasound
of the gallbladder in the
same patient demonstrates
several stones ſt within its
lumen. The calculi are
echogenic and demonstrate
posterior acoustic shadowing
. (Right) A spot fluoroscopic
image from the ERCP
procedure demonstrates a
filling defect near the distal
end of the dilated CBD ,
consistent with
choledocholithiasis ſt.
Contrast also has refluxed into
the gallbladder , where
multiple other gallstones
appear as filling defects in the
lumen of the gallbladder.
(Left) Longitudinal ultrasound
shows a hyperechoic stone ſt
with dense posterior
shadowing present in the
CBD . The gallbladder
contains an additional stone
st within its lumen. (Right)
Several stones ſt are present
in the CBD , causing mild
extrahepatic biliary ductal
dilation. Color Doppler is
helpful to distinguish the CBD
(which does not fill in with
color) from the adjacent
vasculature.
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