Gallbladder ultrasound helps to diagnose cholangitis, cholecystitis, dyskinesia of the gallbladder and biliary tract, gallstone disease, parasitic diseases, developmental abnormalities (agenesis, dysplasia, diverticula of the gallbladder, atresia of the bile ducts, etc.). During the study, the size of the organ, the thickness of its walls, the consistency of the contents, the architectonics of extrahepatic bile ducts are evaluated. In order to assess the functional state of the biliary system, gallbladder ultrasound is performed after taking a choleretic breakfast.
Gallbladder ultrasound is a targeted study of the topography, structure and function of the gallbladder and biliary tract. Gallbladder ultrasound can be an independent study or part of a comprehensive ultrasound of the abdominal cavity. In gastroenterology, biochemical liver tests, duodenal probing, cholecystography, MR cholangiography, abdominal MRI, etc. are used to examine the gallbladder and biliary system. Among these diagnostic methods, gallbladder ultrasound is the primary study performed to obtain indicative data on the condition and degree of organ dysfunction.
Indications
A gastroenterologist, a surgeon can direct an gallbladder ultrasound.
In the structure of gastroenterological pathology, diseases of the gallbladder and biliary tract occupy the second place in prevalence after diseases of the gastroduodenal zone. Among them there are functional (biliary dyskinesia), parasitic (opisthorchiasis, echinococcosis), inflammatory (cholecystitis, cholangitis, cholecystocholangitis), metabolic diseases (cholelithiasis), developmental abnormalities (agenesis, hypoplasia of the gallbladder, additional or intrahepatic gallbladder, diverticula of the gallbladder, atresia of the bile ducts, cystic expansion of the choledochus, etc.). All these diseases can be successfully diagnosed by gallbladder ultrasound.
Quite often in clinical practice, ultrasound of the liver and gallbladder is performed simultaneously. This is due to the anatomical and functional unity of the organs of the hepatobiliary system connected by the duct system, and possible secondary liver damage in diseases of the gallbladder and vice versa.
Gallbladder ultrasound can be prescribed for severity and pain in the right hypochondrium, complaints of nausea and bitterness in the mouth, jaundice of the skin and sclera (including prolonged jaundice of newborns), dyspepsia, painful palpation of the gallbladder area, etc.
Ultrasound procedure
A few days before the study, food that causes gas formation is excluded from the diet, enzyme preparations are prescribed according to indications.
Gallbladder ultrasound is performed on an empty stomach. Also, it is not recommended to drink 1 hour before the study.
During the study, the patient lies on the couch, and the doctor conducts a polypositional scan of the right hypochondrium: lying on his back and on his left side, standing, at the height of inspiration. In the process of ultrasound, the location and contours of the gallbladder are determined, the dimensions of the organ in transverse and longitudinal sections (length, width, volume, wall thickness) are measured, respiratory mobility is fixed, additional inclusions in its cavities are detected, etc. When evaluating extrahepatic bile ducts, attention is paid to their location, diameter, condition of the walls and lumen. Intrahepatic ducts are normally not detected. The unchanged gallbladder is visualized as an echonegative structure adjacent to the dorsal surface of the right lobe of the liver, with a homogeneous homogeneous content. The shape of the gallbladder is pear-shaped, rounded or oval, the contours are smooth and clear. The size of the gallbladder varies depending on age, so an ultrasound specialist should correlate the data obtained with the age norm.
To perform an gallbladder ultrasound to determine the function, the patient must take with him a trial breakfast (egg yolk, cream – the nature and volume is prescribed by the doctor) or the drug hofitol in the form of drops. The study is carried out in 4 stages and takes about 1 hour: the first examination is performed on an empty stomach, the next three – at regular intervals (every 10-15 minutes after taking a trial breakfast).
Gallbladder ultrasound with the determination of function is performed in the position of the child in various positions: lying on his back and on his side, if necessary – sitting and standing. The main detectable indicators are the duration of the contraction phase, the effectiveness of bile excretion, the state of the Oddi sphincter. With undisturbed motor function of the gallbladder, the reduction in the volume of the organ 35-50 minutes after eating breakfast is at least 60-70%. The cost of gallbladder ultrasound with the determination of the function of the child is higher than the price of a conventional study.
Based on the results of the study, the ultrasound diagnostics doctor draws up a conclusion, to which he attaches pictures (if any). With the results of gallbladder ultrasound, the patient is recommended to visit the specialist who prescribed the study.
