Ultrasound.Guide
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Gallbladder
Introduction to Gallbladder Ultrasound
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Case
37 y.o. female
1d epigastric pain --> right back
No past medical history
Some nausea, no fever, no vomiting, no dysuria
Mild tenderness to right flank/ RUQ
UA small blood, not pregnant
Diagnosis?
Imaging?
Treatment?
Narration
37yo With Right Side/ Upper Abdominal Pain
Ultrasound A
Ultrasound B
Narration
Abdominal Pain
Abdominal pain: the #1 ED complaint
Cholelithiasis:
10-20% adults in US (20 million)
1-3% of these with symptoms annually
Renal colic 1 in 11 persons
2 million ED visits annually for flank or back pain
70% of patients with urolithiasis get a CT
though CT has not changed management…
Ultrasound!!!
Narration
Probe Selection And Approach
Curvilinear probe
Can use phased array to scan between ribs
Recommend start with transverse subcostal window
Have patient take a deep breath if possible
Narration
Probe Selection And Approach
Curvilinear probe
Can use phased array to scan between ribs
Can move up (intercostal), lateral (coronal)
Sagittal views
May help to have patient turn to left lateral decubitus or even sit or stand
Narration
Lessons
✓
Introduction
.
Normal Anatomy.
Gallstones.
Cholecystitis.
Other I.
Other II.
Common Bile Duct I.
Common Bile Duct II.
Summing Up.
Author:
Dr. Christopher L Moore
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