Gall-bladder

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GB wall lesions
GB mucocele
Cholecystectomy

Normal Anatomy of Gall bladder:

normal sonographic anatomy of the GB     parts of normal gall bladder

sonography of normal GB anatomy    ultrasound image of normal GB

The above ultrasound images show the normal anatomy of the gall bladder taken from different angles of the transducer during sonography. The parts seen here are the fundus, body, neck and the cystic duct. Note the close relation of the cystic duct to the portal vein. The cystic duct is well seen and appears tortuous in these images.

1) Carcinoma of gall bladder:

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gall bladder mass     ultrasound image of gall bladder mass

This a middle aged male patient who presented with constipation. Ultrasound images of the liver and gall bladder reveal an ominous mass infiltrating the gall bladder wall with invasion of the right lobe of liver. There is also a large calculus seen in the gall bladder. These ultrasound images are diagnostic of gall bladder carcinoma. Images taken using a Toshiba Nemio 30 sonography machine, courtesy of Dr. Vikas Arora, Radiologist, Ferozepur, India.

2) Gall bladder duplication:

.two gall bladders seen       both gall bladders are well distended

Duplicate gall bladders in a child        Two functional gall bladders in a child

Double gall bladder        Duplication of GB is a rare variant

Abdominal sonography of a neonate revealed distended gall bladder with a similar, anechoic, tubular structure adjacent to it. Detailed examination revealed it to be a duplicate gall bladder. These ultrasound images of duplication of the gall bladder reveal 2 gall bladders adjacent to each other with 2 separate cystic ducts. After meals, both the gall bladders showed normal emptying. This is very rare, as it shows that both sacs are fully functional and connected to the Common bile duct. Images courtesy of Mr. Shlomo Gobi, Israel.

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3) Mirizzi syndrome:

ultrasound image of stone in cystic duct       sonography of liver showing dilated biliary tree

ultrasound image of Mirizzi syndrome       artist's view of Mirizzi syndrome

This patient presented with abdominal pain. Sonography reveals a well distended gall bladder with a stone in the neck of the gall bladder/ or cystic duct (see top). Ultrasound images of the liver reveal intrahepatic biliary tree dilatation, with a common bile duct (CBD) of normal calibre. Sonographic images of the liver give a false impression of the calculus being in the hepatic duct, due to the close proximity of the stone in the gall bladder neck. These ultrasound images are diagnostic of Mirizzi syndrome. This syndrome is caused by impacted calculus in the Gall bladder neck or cystic duct causing extrinsic compression of the common hepatic duct. A common predisposing factor for this is the low insertion of the cystic duct into the common hepatic duct. This makes the cystic duct almost parallel to the common hepatic duct. Ultrasound images are taken with a Toshiba Nemio 30 scanning machine, courtesy of     Dr. Vikas Arora, Ferozepur, India. Artist's rendition of the syndrome courtesy of Dr. Anatoly Garkusha, Kiev, Ukraine. 

Reference: http://www.emedicine.com/radio/topic451.htm (free article)

 

 

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  This page was last edited on: Monday November 10, 2008 02:40 PM  

Copyright ©   2007- All rights reserved- www.ultrasound-images.com Dr. Joe Antony, MD,    265, Girinagar, Cochin- 20, India.

Contact: joe@ultrasound-images.com or drjoea (at) gmail.com