By Bates J.

A complete consultant to stomach ultrasound, together with simple anatomy, method and ultrasound appearances including the most typical pathological procedures. could be hugely illustrated with prime quality scans, many in color.

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2 LS through the IVC. 3 LS through the midline, level of the aorta. 4 Longitudinal oblique section through the CBD. 5 Transverse oblique section through the hepatic venous confluence. 6 TS through the level of the porta hepatis. 7 TS at the level of the pancreas. qxd 40 6/30/04 5:37 PM Page 40 ABDOMINAL ULTRASOUND References 1. UK Association of Sonographers. 2001 Guidelines for Professional Working Standards – Ultrasound Practice. UKAS, London. 2. Couinaud C. 1954 Lobes et segments hépatiques; note sur l’architecture anatomique et chirugicale du foie.

Reduce the TGC and/or power to make sure you have not saturated the echoes distal to the gallbladder (see Chapter 3). A contracted, stone-filled gallbladder, producing heavy shadowing, can be difficult to identify due to the lack of any contrasting fluid in the lumen. Beware the folded gallbladder Duodenum mimicking gallbladder pathology ● ● The close proximity of the duodenum to the posterior gallbladder wall often causes it to invaginate the gallbladder. Maximize your machine settings to visualize the posterior gallbladder wall separate from the duodenum and turn the patient to cause the duodenal contents to move.

An enlarged gallbladder is frequently referred to as hydropic. It may be due to obstruction of the cystic duct (see below) or associated with numerous disease processes such as diabetes, primary sclerosing cholangitis, leptospirosis or in response to some types of drug. A pathologically dilated gallbladder, as opposed to one which is physiologically dilated, usually assumes a more rounded, tense appearance. 11 cont’d (B) Gallstone Ileus. hands. 4 Both ultrasound and cholescintigraphy are used in monitoring postoperative biliary leaks or haematoma (Fig.

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