GALLBLADDER AND BILIARY TRACT | Normal Anatomy Of Gallbladder, Enlarge gallbladder (Distended) | Indication, Preparation

• Pain in the right upper abdomen:suspected gallstones and/or cholecystitis.

Indications

• Pain in the right upper abdomen:suspected gallstones and/or cholecystitis.
• Jaundice.
• Palpable right upper abdominal mass.
• Recurrent symptoms of peptic ulcer.
• Pyrexia of unknown origin.

Preparation

• preparation of the patient.

                        The patient should take nothing for 8 hrs pretending the examination.

• position of the patient.

                        Start with the patient lying supine: the patient may latter need to be turned on to left side or examined errect or on hands and knees.apply coupling agent both side of abdomen, because, what ever the symptons, both side of the upper abdomen should be scanned.

Normal anatomy of gallbladder

on the longitudinal scan the gallbladder will apears as an echo-free, pear-shaped structure. it is very variale in position , size and shape, but the noemall gallbladder is seldon m ore than 4cm wide.the gall bladder may be found below the level of superior iliac crest. it may be to the left of the midline. if not located in the normal position, scan the whole abdomen, starting on the right side.

Enlarge gallbladder (distended).

The gall bladder is enlarged if it exceeds 4cm in width (transverse diameter).

The normal gallbladder may appear distended when the patient is de-hydrated, has been on a low-fat diet or intravenous nutrition, or hass been immoblizied for some time. if there is no clinical evidence of cholecystitis, and if the gallbladder wall does not appear thickend on ultrasound.

If there is no contraction, search for:

1. A gallstone or other causes of obstruction within the cystic duct.
2. A stone or other obstruction in the common bile duct. 
3. If the gallbladder is distended with thin walls and filled with fluid, there may be a mucocele. this does not usually result in local tenderness.