By Jane A. Smith (formerly Bates) MPhil DMU DCR
As an increasing number of practitioners are hoping on ultrasound as an authorized, secure, and reasonably-priced diagnostic instrument in daily perform, its use in diagnosing stomach difficulties is instantly expanding. This up to date version contains insurance of easy anatomy, approach, and ultrasound appearances, as well as the most typical pathological procedures. It serves as either a realistic, clinically correct guide and source for pros, in addition to a useful textbook for college kids coming into the sphere. * Over 500 illustrations and top of the range scans sincerely convey stomach anatomy. * functional and clinically appropriate insurance addresses the troubles of either practitioners and scholars. * Succinct, finished chapters express small print.
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Additional resources for Abdominal Ultrasound How, Why and When
Example text
14 Mirizzi syndrome: a large stone in the neck of the gallbladder (arrow) is compressing the bile duct, causing intrahepatic duct dilatation. The lower end of the CBD remains normal in calibre. THE CONTRACTED OR SMALL GALLBLADDER Postprandial The most likely cause is physiological and due to inadequate preparation. The normal gallbladder wall is thickened when contracted, and this must not be confused with a pathological process. Always enquire what the patient has recently eaten or drunk (Fig.
1991 Contrast cholangiography versus ultrasonographic measurement of the ‘extrahepatic’ bile duct: a two-fold discrepancy revisited. Journal of Ultrasound in Medicine 10: 653–657. qxd 6/30/04 5:40 PM Page 41 41 Chapter 3 Pathology of the gallbladder and biliary tree CHAPTER CONTENTS Cholelithiasis 41 Ultrasound appearances 42 Choledocholithiasis 45 Biliary reflux and gallstone pancreatitis 47 Further management of gallstones 47 Enlargement of the gallbladder 48 Mucocoele of the gallbladder 48 Mirizzi syndrome 48 The contracted or small gallbladder 50 Porcelain gallbladder 50 Hyperplastic conditions of the gallbladder wall 51 Adenomyomatosis 51 Polyps 53 Cholesterolosis 53 Inflammatory gallbladder disease 54 Acute cholecystitis 54 Chronic cholecystitis 56 Acalculous cholecystitis 56 Complications of cholecystitis 57 Obstructive jaundice and biliary duct dilatation 58 Assessment of the level of obstruction 58 Assessment of the cause of obstruction 61 Management of biliary obstruction 64 Intrahepatic tumours causing biliary obstruction 64 Choledochal cysts 64 Cholangitis 66 Biliary dilatation without jaundice 66 Postsurgical CBD dilatation 66 Focal obstruction 67 Pitfalls 67 Obstruction without biliary dilatation 67 Early obstruction 67 Fibrosis of the duct walls 67 Other biliary diseases 67 Primary sclerosing cholangitis 67 Caroli’s disease 68 Parasites 70 Echogenic bile 71 Biliary stasis 71 Haemobilia 72 Pneumobilia 72 Malignant biliary disease 73 Primary gallbladder carcinoma 73 Cholangiocarcinoma 74 Gallbladder metastases 76 Ultrasound is an essential first-line investigation in suspected gallbladder and biliary duct disease.
11B). If the condition is not promptly diagnosed, recurring cholangitis leading to secondary biliary cirrhosis may result. On ultrasound the gallbladder may be either enlarged or contracted and contain debris. A stone impacted at the neck may be demonstrated together with dilatation of the intrahepatic ducts with a normal-calibre lower common duct (Fig. 14). The diagnosis, however, is difficult, and ERCP is generally the most successful modality. 13 (A) Postoperative bile collection in the gallbladder bed.