Bedside Gallbladder Ultrasonography

imagesClinical suspicion of cholecystitis or biliary colic:

   imagesAbdominal pain, particularly right upper quadrant (RUQ), epigastric

   imagesRight flank pain

   imagesRight shoulder pain


   imagesSepsis without source


imagesNone: No contrast or radiation


imagesAllergy to the ultrasonography gel


imagesRUQ of abdomen at expected location of gallbladder (GB)


imagesUsing a standard 3.5- to 5.0-MHz probe, scan the RUQ of the abdomen in the longitudinal plane under the costal margin using the liver as an acoustic window (FIGURE 34.1)

imagesIf the GB is not readily identified:

   imagesAsk the patient to take slow deep breaths because the GB moves significantly with respiration

   imagesHave the patient move to the left lateral decubitus position

   imagesPlace the probe in the intercostal space to avoid bowel gas and rib shadows

imagesOnce the GB is found, confirm by identifying associated structures:

   imagesEchogenic gallstones in the lumen casting echolucent shadows (FIGURE 34.2)

   imagesMain lobar fissure of the liver points toward the GB neck and also connects the portal vein

   imagesCommon bile duct (CBD) usually runs between the GB and the portal vein (FIGURE 34.3)

imagesIdentify signs of cholecystitis (TABLE 34.1)


FIGURE 34.1 Biliary ultrasonography: To locate the gallbladder, do a costal margin sweep first.

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Aug 9, 2016 | Posted by in EMERGENCY MEDICINE | Comments Off on Bedside Gallbladder Ultrasonography
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