GB wall lesions

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Ultrasound images of lesions of gall bladder wall:

 

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1) Segmental adenomyomatosis of gall bladder:

 

ultrasound image of gall bladder      Segmental thickening of GB wall

Ultrasound image of segmental adenomyomatosis of GB

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This patient underwent routine sonography of the abdomen. Ultrasound images of the gall bladder reveal thickening and constriction of the mid segment dividing the lumen into a fundic area and another part towards the neck. There is also evidence of small calculi in the fundic segment of the gall bladder. These ultrasound images suggest segmental adenomyomatosis of the gall bladder. Adenomyomatosis of the gall bladder may be segmental, diffuse or fundal. Images taken using Toshiba Powervision ultrasound and color doppler machine, courtesy of Dr. Ravi Kadasne, Al Ein, UAE.

Reference:

Segmental adenomyomatosis of gall bladder

2) Diffuse adenomyomatosis of gall bladder:

sonography of adenomyomatosis of GB     adenomyomatosis of gall bladder -sonographic features

These gall bladder ultrasound images show multiple echogenic foci within the GB wall with V-shaped comet-tail artefacts. There is also diffuse thickening of the gall bladder wall. The comet tail artefacts are the result of minute cholesterol calculi within small sinuses or diverticuli (Rokitansky -Aschoff sinuses) in the Gall bladder wall. These findings suggest adenomyomatosis of the gall bladder. Ultrasound images are courtesy of Dr. Ravi Kadasne, UAE.

 

 

3) Tiny polyp of the gall bladder wall:

 

Small gall bladder polyp:

small benign polyp of the gall bladder

This ultrasound image shows a small polyp of the inferior wall of the gall bladder. Note the small base of the polyp, suggesting its benign nature. Such polyps are usually the result of chronic inflammation. Ultrasound image courtesy of Dr. Ravi Kadasne, UAE. He used a Philips IU22 machine to obtain this image. 

Reference: http://www.emedicine.com/MED/topic2711.htm

 

4) Large gall bladder polyp:

showing a GB polyp     Color Doppler imaging of GB polyp

Grey scale B-mode image of GB polyp    The vessel seen entering the GB polyp (Power Doppler)

This middle aged, female, patient had non-specific symptoms for which she underwent routine sonography of the abdomen. Ultrasound, Color Doppler and Power Doppler images of the gall bladder reveal an echogenic, oval, smooth walled solid lesion in the gall bladder lumen. It appears attached to the upper wall of the gall bladder, though some movement was present on real time imaging. Color Doppler images show a vessel, clearly seen entering the mass from the upper wall of the gall bladder. These ultrasound images are diagnostic of gall bladder polyp. Such polyps need to be followed up for increase in size and changes which may suggest malignant transformation. Images taken by Joe Antony, MD, India, using a Toshiba Nemio-XG ultrasound system. 

5) Multiple gall bladder polyps:

case-1:                                                                          case-2:

many polypoid masses along the Gall bladder wall     ultrasound image of multiple GB polyps

These images show multiple, small polyps of the gall bladder (different patients). Ultrasound image on left is courtesy of Dr. Durr-e-Sabih, Pakistan. Image on right is courtesy of Dr. Gunjan Puri, MD, India.

6) Acalculous Cholecystitis:

multiple abscesses of the liver and spleen     edematous distended gall bladder

This patient had severe pain in right hypochondrium and pyrexia. The total leucocyte count was markedly elevated (38000). Sonography of the liver and spleen showed multiple patchy hypoechoic lesions suggestive of multiple minute abscesses. The gall bladder was markedly distended with thickened and edematous wall. Color Doppler imaging (not shown here), revealed increased vascularity of the gall bladder wall. Note absence of GB (Gall Bladder) calculus. These findings suggest acalculous cholecystitis. Ultrasound case study is courtesy of Dr. Vikas Shukla, MD, India.

Reference: http://emedicine.medscape.com/article/365553-overview (free article and images).

7) Calculous cholecystitis:

huge calculus in GB    edematous inflamed GB wall

This female patient underwent sonography of the gall bladder which showed a large calculus (6 cms.) within the lumen. The gall bladder (GB) walls show considerable thickening with layers of hyperechoic and hypoechoic regions. These ultrasound images are suggestive of calculous cholecystitis. In this case, the GB calculus obstructs the flow of bile with resulting edema and inflammation of the GB wall. Images are courtesy of Shlomo Gobi, Israel.

Reference: http://emedicine.medscape.com/article/171886-overview

 

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  This page was last edited on: Tuesday February 23, 2010 03:10 PM  

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

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