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This patient presented with right upper quadrant abdominal pain. There was RUQ tenderness on exam, but no fever, rebound or Murphy sign. A point-of-care ultrasound was performed to assess for signs of cholecystitis and the following image was obtained. This prompted the operator to ask, “What the heck?” What structures are visible here? How couldRead more

The normal gallbladder wall should measure less than 3-4mm. It is recommended that this measurement be taken through the anterior wall of the gallbladder, since posterior acoustic enhancement will often make posterior measurements inaccurate. The image above was taken in a patient with cirrhosis, chronic ascites, and no acute complaints of upper abdominal pain. WhileRead more

One of the most common pitfalls in gallbladder sonography is confusion with the structure which abuts it in the right upper quadrant – the duodenum. This loop of bowel can easily be mistaken for the gallbladder especially if it contains a mixture of fluid and solid materials. So how can we tell them apart? TheRead more