Diagnostic Ultrasound - Abdomen and Pelvis

Echogenic Material in Gallbladder
Sludge/Sludge Ball/Echogenic Bile
Sludge/Sludge Ball/Echogenic Bile
(Left) Transverse ultrasound of
the right upper quadrant
shows a markedly distended
sludge-filled gallbladder ſt in
acalculous cholecystitis.
Although the wall was not
thick, the patient was treated
with percutaneous drainage.
(Right) Longitudinal decubitus
ultrasound of a nondistended
gallbladder shows
intraluminal echoes from
small nonshadowing sludge
balls ſt. Some display the
"comet tail" artifact st.
Differential Diagnoses: Biliary System
Complicated Cholecystitis
Complicated Cholecystitis
(Left) Transverse ultrasound of
the gallbladder fossa shows
the gallbladder lumen to be
filled with membranes ſt with
no wall. There is
pericholecystic fluid st and
echogenic fat in this
diabetic patient with
gangrenous cholecystitis.
(Right) Transverse ultrasound
shows a distended gallbladder
with intraluminal sludge,
discontinuous wall ,
pericholecystic abscess st,
and gas in the wall ſt from
emphysematous cholecystitis.
Drainage Catheter
Tumor: Primary or Secondary
(Left) Transverse ultrasound
following percutaneous
drainage for acalculous
cholecystitis in a sick patient.
The pig tail catheter ſt is
looped in the gallbladder
lumen, which contains sludge
st. The wall is indistinct.
(Right) Longitudinal
ultrasound shows a markedly
distended gallbladder (15 cm)
with low level intraluminal
echoes ſt. The lumen was
filled with necrotic
adenocarcinoma with muscle
invasion in the neck only.
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