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Flashcards in Gallbladder Deck (29):
1

What percentage of patients with cholecystitis have choledochalithiasis?

15%

2

Patients with choledochalithiasis require what before cholecystectomy?

ERCP

3

What landmark goes from gallbladder to right portal vein?

Main lobar fissure

4

If the gallbladder is filled with stones it will appear...

echogenic line with clean shadowing

5

If a stone is seen in the gallbladder neck, you must scan the patient...

In two positions

6

In the transverse exam the gallbladder is ..... relative to the right kidney.

Anterior and medial

7

What is Phrygian cap with relation to gallbladders?

Fold in the fundus of the gallbladder

8

What are junctional folds?

Folds in gallbladder near the neck

9

Normal gallbladder size is

<10 cm sagittal; transverse <5cm outer wall to outer wall

10

Which view is more reliable for detection of gallbladder obstruction?

Transverse

11

Gallstones appear

Mobile (unless impacted), echogenic, and cast acoustic shadows

12

Gallstones in the neck require two views to evaluate...

Mobility of the stone

13

To see the shadowing use...

The highest frequency possible and set the focal zone around the stone

14

What is the primary goal of management of gallbladder polyps?

Prevention of gallbladder carcinoma

15

What polyp characteristics increase concern for gallbladder carcinoma?

Solitary polyp >6mm, >50 years old

16

What is normal gallbladder wall thickness?

<3 mm

17

What is adenomyomatosis?

Mucosal hyperplasia and thickening of the muscular layer of the gallbladder. Cholesterol crystals with short comet tails are produced.

18

Pericholecystic abscess formation is the result of ...

Gallbladder wall perforation

19

What is the course of the common bile duct?

Inferior and medial as it approaches the duodenum

20

Normal common bile duct measures

Less than 7 mm from inside wall to inside wall

21

After cholecystectomy, the common bile duct can dilate up to

1 cm

22

Use the .... plane to to measure the common bile duct.

Sagittal with transducer perpendicular to costal margin toward patient's right. CBD is anterior to portal vein

23

What is the WES sign?

Gallbladder so filled with stones that it is not seen except for an echogenic line with shadowing. Wall-echo-shadow

24

How specific for cholecystitis is the sonography Murphy's sign?

87%

25

Presence of gallstones in combination with positive Murphy's sign has a ... positive predictive value for acute cholecystitis.

92%

26

Patient's with acute cholecystitis must have ... evaluated before surgery?

Common bile duct

27

How is the diagnosis of a calculus cholecystitis made?

Gallbladder dissension, intraluminal debris, and positive sonography Murphy's

28

What is complicated cholecystitis?

Gangrenous cholecystitis, emphysematous cholecystitis, and perforation

29

Excision of gallbladder polyps is recommended when...

>1 cm, pt older than 50, any polyp that is growing regardless if less than 1 cm