How is an ultrasound examination of the gallbladder performed?

Ultrasound of the gallbladder is a non-invasive research method that provides a complete picture of the condition of the gallbladder, as well as the bile ducts. Often, the gallbladder is diagnosed in conjunction with all abdominal organs or the liver.

Indications and contraindications for the procedure

The need for an ultrasound examination of the gallbladder is usually diagnosed by a gastroenterologist. He conducts a general examination and, based on the patient’s complaints, prescribes an ultrasound scan. Indications for the procedure are as follows:

• Constant pain in the area of ​​the right hypochondrium, which does not stop even after taking analgesics;
• Feeling of heaviness in the liver area;
• Bitter taste in the mouth;
• Yellow coloring of the skin and mucous membranes;

There are also reasons the presence of which is a reason to check the condition of the gallbladder using an ultrasound procedure:

• Poor nutrition, when the diet consists of unhealthy foods, fatty, spicy, smoked foods;
• Long-term adherence to a low-calorie diet;
• Obesity;
• Long-term use of medications.
• There are no contraindications to the procedure. The exception is damage to the skin in the area where the device comes into contact with the body.

How to prepare for the procedure

Preparation for an ultrasound scan of the gallbladder is almost the same as for an ultrasound examination of all abdominal organs. Can I eat before the procedure? Before the study, it is recommended to follow a simple diet. So, a couple of days before the procedure, you should exclude the following foods from your diet:

1. whole wheat bread;
2. products made from yeast dough;
3. raw vegetables and fruits;
4. dairy products;
5. beans and peas;
6. lemonades, strong tea and coffee.

You should also avoid fatty foods and alcohol.

During the period of preparation for ultrasound of the gallbladder, you can eat:

1. low fat cottage cheese,
2. steamed fish,
3. porridge cooked in water,
4. beef or chicken meat.

To reduce gas formation in the intestines, you can start taking anti-flatulence medications, for example, Espumisan, 2-3 days before the procedure; regular activated carbon is also suitable. To improve digestion, drugs such as Mezim or Festal are used.

Typically, an ultrasound of any abdominal organ is performed in the morning on an empty stomach. The day before you need to follow some rules:

• Dinner should be light, do not eat fatty foods.
• The last meal should take place no later than 7 pm;
• Before going to bed, you need to empty your bowels. To do this, you can use mild laxatives, microenemas or glycerin suppositories.

In the morning immediately before the procedure, you should skip breakfast if the ultrasound is performed before noon.

Sometimes diagnostics are scheduled for the afternoon. In this case, a light breakfast is allowed, but at least 5 hours must pass after eating before the procedure begins. You should not drink anything 2 hours before the ultrasound. Also, you should not smoke cigarettes or chew gum before the test.

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Infants also need to prepare for the procedure in advance. So, they cannot be fed or watered 2 hours before the ultrasound.

Ultrasound examination of the gallbladder is done on an empty stomach due to the fact that in this state it is completely filled with bile and increases in size.

If you eat or drink water before the procedure, bile will begin to be excreted, and the organ will become much smaller, which is why the test results may be distorted. Careful preparation for an ultrasound scan of the gallbladder ensures that the correct diagnosis is made and the necessary treatment is prescribed.

Methodology of the procedure

In order to get a complete picture of the condition of the gallbladder, it is better to do an ultrasound of all abdominal organs. After diagnosis, you should contact a gastroenterologist so that a specialist can decipher all the results and explain the condition of the organ.

Ultrasound of the gallbladder is of two types - simple and with determination of function .

• A simple ultrasound is done using an external probe through the anterior abdominal wall.

The patient undresses to the waist and lies down on the couch. Before starting the procedure, the doctor applies a special gel to the area of ​​study to eliminate interference in the form of an air gap. Sometimes the patient may be asked to take a deep breath or hold his breath. This is necessary to obtain a more accurate result when the gallbladder is hidden by intestinal loops.

If the doctor asks the patient to stand up and bend forward a few times, you should not be surprised: in this way the doctor is trying to diagnose the presence of sand or stones in the organ.

• Ultrasound of the gallbladder with determination of function has other names - ultrasound diagnostics with a choleretic breakfast, dynamic echocholescintigraphy, ultrasound with a functional test or load.

This type of study allows you to determine the contractility of the gallbladder in real time.

The procedure consists of two stages. First, a simple ultrasound is performed. Afterwards, the patient needs to eat several foods to choose from:

1. 250 ml of heavy cream, cottage cheese or sour cream with twenty-five percent fat content;
2. several pieces of dark chocolate and banana;
3. 2 raw or boiled chicken yolks;
4. bread with butter;
5. sorbitol solution.

Next, the procedure is carried out 3 times with intervals of 5, 10 and 15 minutes between each procedure.

If during the procedure the patient complains of pain, the doctor needs to record its intensity, nature and area of ​​distribution.

Decoding the results

During the study, the doctor examines the following indicators:

• location and mobility of the gallbladder;
• condition of the walls of the organ;
• diameter of the biliary tract;
• contractile function of the organ;
• the presence of sand, stones, polyps in the bladder.

Normally, the gallbladder in adults should have the following dimensions:

• Length - 70-100 mm;
• Width - 30-50 mm;
• Transverse size - 30-35 mm;
• Volume - from 300 to 700 cubic mm;
• Wall thickness - up to 40 mm.

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Normally, the shape of the gallbladder is pear-shaped with clear contours. The bottom of the bladder may protrude from under the lower edge of the liver.

Detection of any deviations from normal indicators is a reason for a more detailed examination of the organ.

What does the examination show?

Using an ultrasound of the gallbladder, you can determine the presence or absence of many diseases and conditions. Some of them are presented below.

1. Acute cholecystitis. With this disease, the wall of the organ is thickened by more than 5 mm, and there are a large number of internal partitions. In addition, increased blood flow is observed in the gallbladder artery. In general, the entire organ increases in size.
2. Chronic cholecystitis. The disease is characterized by the following symptoms:
   • reduction in organ size;
   • the wall of the gallbladder is thickened, compacted and deformed;
   • the contours of the organ are unclear;
   • there are small inclusions in the lumen of the bladder.
3. Dyskenesia of the gallbladder is characterized by bending of the organ and increased tone of the walls of the gallbladder.
4. Gallstone disease is characterized by the presence of stones in the gallbladder. Usually these formations are small in size and shift when the body position changes. Ultrasound shows an echo shadow (dark spots behind the stone), and an increase in the thickness of the walls of the organ, which have unclear outlines, is also observed.
5. Gallbladder polyps. Signs of this pathology that can be seen during an ultrasound include the presence of round formations on the walls of the organ. If the diameter of the polyp exceeds 10 mm, then the formation may be malignant. In order to confirm or refute this, repeated ultrasound examinations are carried out, with the help of which the growth of tumors can be tracked.

Various tumors can appear in the gallbladder. On ultrasound they can be identified by the following indicators:

• deformation of the contours of the organ;
• significant thickening of the walls of the gallbladder;
• the presence of formations not exceeding 10-15 mm.

The following pathologies can also be detected using ultrasound:

• congenital anomalies (for example, gallbladder torsion);
• agenesis - a condition when a person does not have a gallbladder from birth;
• double gallbladder,
• diverticulum - protrusion of the walls of an organ.

An accurate diagnosis after the study can only be made by a qualified specialist; it is pointless to decipher the result on your own. Any pathology must be clarified by re-examination after a few weeks.

Ultrasound of the gallbladder is the simplest and most effective research method. With its help you can examine the organ very accurately. The gallbladder can also be examined by probing, but this is a very unpleasant procedure that is contraindicated in many patients. In addition, the state of the organ is examined using MRI, but this is unreasonably expensive.

Currently, almost all gallbladder diseases can be cured. It is important to consult a doctor in a timely manner and not delay treatment.

Ultrasound of the gallbladder: simple and with determination of function, how to prepare Link to main publication

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Ultrasound of the gallbladder with functional test

18.12.2018

Ultrasound of the gallbladder with stress is a non-invasive type of instrumental diagnostics that shows complete information about the functional characteristics of the organ. Often, echography of the gallbladder is done in conjunction with ultrasound examination of the liver tissue. Ultrasound with a functional test evaluates the dynamics of the condition and changes in the functioning of the organ under study.

Indications for performing an echographic examination

Ultrasound of the gallbladder with a load is performed in the following situations:

• pain in the right hypochondrium that is not eliminated by antispasmodic drugs (for example, No-shpa, Papaverine);
• bitter taste;
• icteric coloration of the skin and mucous membranes;
• long courses of medications;
• changes in biochemical blood parameters (for example, ALT, AST);
• presence of cholelithiasis;
• impaired motility of the biliary tract;
• assessment of the condition of the biliary tract in case of suspected cancer pathology;
• when selecting combined oral contraceptives;
• in case of fat metabolism disorders;
• to assess the effectiveness of the therapy.

Contraindications

Carrying out an ultrasound to assess the functional state of the gallbladder has no contraindications. The manipulation is not performed if the skin in the area being examined is damaged (wounds, infections, burns).

Preparatory measures for ultrasound with function assessment

The preparatory plan for an ultrasound of the gallbladder with a choleretic breakfast is no different from an ultrasound examination of the abdominal organs.

Preparation for an ultrasound with assessment of gallbladder function begins 2-3 days before the procedure. Before ultrasound examination it is recommended:

• exclude alcohol;
• do not consume foods that contribute to gas formation in the intestines - fruits (apples, pears), vegetables (cucumbers, tomatoes), legumes (beans, peas), rich yeast products, brown bread, carbonated drinks, dairy products.

Recommended diet for preparation:

• steam-cooked meat and fish with low fat content;
• cottage cheese with a low fat content (up to 10-15%);
• cereals cooked in water;
• hard-boiled eggs.

REFERENCE! During meals, take enzyme preparations (Creon, Mezim, Pangrol) to digest food. Medicines against gas formation in the intestines (Antiflat, Motilak, Plantex) are also used.

The evening before the test you need to:

• have a light dinner (last meal no later than 19:00);
• empty the intestines (naturally or with the help of laxatives, for example, Lactulose, Duphalac).

In the morning before the ultrasound scan:

• do not have breakfast if the procedure is planned before 12:00;
• a light breakfast is possible - a mug of tea and a couple of crackers (the interval from breakfast to the ultrasound is at least 6 hours);
• 3-4 hours before the study, liquid intake is prohibited;
• no smoking.

REFERENCE! The ban on food and liquid intake is due to the fact that the processes stimulate the secretion of bile. This makes further visualization of the organ difficult.

Before visiting the doctor before the test:

• boil a few hard-boiled eggs (2-3 pieces), separate the yolks (they will be needed for choleretic load);
• take a towel (diaper) to remove the special gel from the body after the manipulation.

Research methodology

Ultrasound of the gallbladder with determination of function takes place in 4 successive stages.

First stage

Similar to conventional ultrasound examination. The procedure is carried out before taking a choleretic breakfast and is performed using a special sensor using a gel. The patient lies on his back.

Second phase

The patient takes breakfast prepared the day before. The ultrasound examination is repeated, the results are compared with those before the load.

Third stage

Wait 15-20 minutes and repeat the ultrasound examination.

Fourth stage

A repeat study is done 40-45 minutes after taking a special breakfast.

The difference between this echography and an ordinary ultrasound is that during a stress test the functional state of the gallbladder is assessed.

Evaluation of ultrasound results with stress

When performing a manipulation, the diagnostician looks at:

• location of the organ, its displacement;
• shape, parameters, thickness and condition of the walls;
• ducts and their diameter;
• bladder contractility;
• presence of microliths and other formations.

The normal parameters of the gallbladder are:

• length within 7-10 cm;
• width no more than 3-5 cm;
• diameter – 3-3.5 cm;
• capacity – 30-70 cm3;
• wall thickness – up to 0.4 cm;
• common bile duct – 0.6-0.8 cm;
• diameter of lobar ducts – up to 0.3 cm;
• clear contours.

The contractility of the organ is assessed according to the following parameters:

• duration of the contraction phase;
• biliary excretion and its effectiveness;
• sphincter of Oddi tone.

When performing an ultrasound of the gallbladder to determine the function, the organ’s reactions to the administration of choleretic agents (test breakfast) are distinguished:

• type 1 – gradual contraction lasting up to half an hour, followed by relaxation at 45 minutes;
• type 2 – contraction of the organ for up to 15 minutes, then persistent contraction;
• type 3 – contraction of low strength, the shape of the organ does not change or decreases;
• type 4 – organ contraction for up to 15 minutes, then relaxation, contraction, complete relaxation at 45 minutes;
• type 5 - relaxation of the bladder up to 15 minutes, contraction in the interval between 15 and 30 minutes, relaxation at 45 minutes.

If type 4 or 5 of gallbladder contractility is detected, this is considered a manifestation of instability of motor function.

Identification of possible pathologies

By means of an echographic examination of the gallbladder, diseases are determined:

• acute inflammation of the gallbladder (cholecystitis), characterized by thickening of the organ wall, increase in size, increased speed of blood outflow in the cystic artery;
• a chronic inflammatory process localized in the gallbladder - a decrease in the parameters of the organ, changes in the walls, lack of clarity of contours, the presence of inclusions in the lumen;
• dyskinesia - an increase or decrease in the tone of the walls of the organ, their increased density, bending of the organ;
• cholelithiasis (cholelithiasis) – the presence of displaced formations in the cavity of the bladder, changes in the contours of the wall;
• polypous growths - defined as round-shaped formations localized on the wall of the organ (with a diameter of more than 10 mm, malignancy of the process is suspected);
• tumors - neoplasms characterized by sizes greater than 10 mm, thickening of the bladder wall, changes in the contours of the organ;
• congenital pathologies - absence of an organ, atypical localization, duplication, protrusion of the wall.

Microliths (stones of small diameter) are not determined by echography. Their presence is determined by an increase in the lumen of the bile ducts above the location of the stone.

Project consultant, co-author of the article: Balyberdina Maria Vyacheslavovna | Gastroenterologist Experience 26 years / Doctor of the highest category

Education:

• Diploma in General Medicine (Medicine and Prevention), Saratov State Medical University (1992)
• Residency in Therapy, Saratov State Medical University (1994)

Methodology, preparation and interpretation of ultrasound of the gallbladder with determination of function Link to the main publication

Source: https://PechenMed.ru/zhelchnyj-puzyr/metodika-podgotovka-i-rasshifrovka-uzi-zhelchnogo-puzyrya-s-opredeleniem-funktsii

Ultrasound of the gallbladder

Impaired functioning of the gallbladder (hereinafter referred to as the gallbladder) affects not only the functioning of the entire digestive system, but also the health of the body as a whole. Any tiny pathologies can develop to extreme stages, and if they are not diagnosed and treated, they can even cause death.

Ultrasound of the gallbladder has long been recognized as one of the simplest and most accessible methods for examination, allowing one to assess the functional state of the organ itself, as well as the bile ducts.

The procedure, despite its simplicity, requires careful preparation of the patient and is distinguished by a special technique.

When is a gallbladder diagnosis necessary?

Gallbladder pathologies are often accompanied by a fairly wide range of varied symptoms, which can also be the result of diseases in other parts of the digestive system. Therefore, to confirm or exclude the presence of pathological processes, ultrasound examination of the gallbladder is recommended for the following symptoms:

• pain under the ribs on the right, not relieved by painkillers;
• discomfort or heaviness in the liver area;
• icterus of the skin and visible mucous membranes;
• feeling of bitterness in the mouth.

In addition to the visible manifestations and complaints of the patient, ultrasound of the abdominal cavity and gallbladder, in particular, is prescribed:

• with cholelithiasis;
• biliary dyskinesia;
• mechanical damage to the abdominal cavity;
• long-term use of medications;
• control of prescribed therapy;
• intoxication of the body (also with alcohol abuse);
• monitoring the development of oncological processes;
• abnormal blood test results (bilirubin, ALT, AST).

Ultrasound of the gallbladder is necessary for people who are obese and who maliciously violate the basic rules of nutrition. These include irregular meals, a preference for spicy, fried, fatty and smoked foods, and a tendency to indulge in low-calorie diets.

Alcohol and fatty foods lead to gallbladder dysfunction

It is impossible to do without examining the organs responsible for the function of storing and transporting bile when prescribing and selecting hormonal contraceptives.

The presence of a woman's predisposition to gallbladder diseases is considered a relative contraindication to the use of hormonal contraceptives.

Taking them can provoke an inflammatory process in the bladder or accelerate the formation of gallstones (stones).

Contraindications

Ultrasound of the gallbladder is a simple and absolutely harmless method for assessing the organs responsible for storing and releasing bile.

This allows it to be performed without fear and risk on pregnant women, young children and weakened adult patients with impaired functioning of the cardiovascular system, liver and kidneys.

The only thing that can become an obstacle to the procedure is a violation of the integrity of the skin at the site where the ultrasound sensor is installed. These could be burn wounds, open injuries, or skin lesions due to infectious, bacterial, or fungal diseases of a severe stage.

What gallbladder diseases does ultrasound detect?

Diagnostics can easily detect almost all pathological processes that occur in the gallbladder and its ducts. These include:

• acute and chronic cholecystitis (inflammation of the bladder);
• cholelithiasis (formation of stones in the cavity of the gallbladder or its ducts);
• choledocholithiasis (stagnation of bile due to blockage of the duct with a stone);
• cholangitis (inflammation of the duct as a result of choledocholithiasis);
• benign and malignant neoplasms;
• hydrocele (accumulation of exudate and mucus due to blockage of the duct);
• dyskinesia (motility disorder).

Gastrointestinal pathologies diagnosed by ultrasound

During an ultrasound examination, the doctor can assess the condition of the liver and identify signs of hepatitis or cirrhosis if present. After removal of the bladder, ultrasound allows for a qualitative examination of the surgical area, which is an important point when monitoring the patient in the postoperative period.

Preparatory process

Preparation for ultrasound diagnostics of the gallbladder, as a rule, does not differ from preliminary measures for ultrasound examination of other abdominal organs. It includes a diet aimed at reducing flatulence, a certain diet, taking medications and cleansing the intestines. You can learn more about the step-by-step preparation for an ultrasound of the gallbladder in this article.

Diet

To minimize the process of gas formation in the stomach and intestines, which can distort the ultrasound photo, the patient should begin preparing for the procedure 3-4 days in advance and adhere to the following diet, excluding the use of:

Preparation for ultrasound of internal organs

• yeast products and grain bread;
• raw vegetables, fruits and legumes;
• fermented milk products;
• fatty, spicy, smoked dishes;
• carbonated drinks and water;
• alcohol-containing products;
• strong tea and coffee.

The diet should consist of:

• from low-fat fish, steamed or boiled;
• soft-boiled eggs (but no more than one per day);
• boiled chicken or beef;
• low-fat cottage cheese;
• porridge on the water.

Diet

To properly prepare for the examination, you should increase the number of meals, but you need to eat in small portions. This approach gives food time to digest and reduces the processes of fermentation and gas formation in the stomach and intestines. The evening before the ultrasound, you should have dinner no later than 19.00 with a light and hearty meal, for example, porridge cooked in water and without added sugar.

If the diagnosis is planned before 12 noon, then in the morning before the ultrasound the patient should refuse breakfast and drinks.

Several hours before the examination, the patient should refrain from chewing gum and smoking.

When conducting the study in the second half, you can have breakfast with a cracker and a glass of tea, and at least 6 hours should pass between the procedure and breakfast.

Ultrasound of the gallbladder is performed strictly on an empty stomach. This ensures that the bladder is filled with bile, and its size increases.

A little liquid, let alone food, will provoke the secretion of bile and the organ will shrink, which will complicate diagnosis.

Medications

During the diet in preparation for an ultrasound, it is recommended to take medications containing pancreatic enzymes (Festal, Mezim, Creon) and medications that relieve flatulence (Espumizan, activated or white carbon, Smecta).

Their intake is mandatory, but you should not abuse them and drink more than 3 times a day.

Considering that it is forbidden to drink liquid 2-3 hours before diagnosis, and the patient regularly takes a course of vital medications, he needs to consult with a specialist in advance to adjust the hours of taking them.

Purgation

The evening before the test, you need to empty your colon. If the patient has a tendency to constipation, then use any laxative, folk remedies or microenemas.

Methodology of the procedure

It would be optimal to do an ultrasound of all digestive organs. This will help identify all possible pathological processes, even those that have not yet manifested obvious signs. The examination can be performed in three different ways, from which the doctor chooses one of the most suitable ones, taking into account the existing symptoms.

Easy way

To perform a simple examination technique, the patient is asked to lie on his back and free the upper abdominal area from clothing. The diagnostician places the sensor on the surface of the skin, having previously applied a special gel to it.

This is done to eliminate the air gap that creates interference and improve the passage of ultrasound. If the bottom of the bladder is covered with loops of the large or small intestine, the patient is asked to take a deep breath and hold his breath, or turn over to the left.

To detect pathological formations in the bladder cavity (calculi, sand), the patient is asked to get up from the couch and lean forward two to three times.

Performing an ultrasound examination of the gastrointestinal tract can be a separate procedure or a stage in the diagnosis of the abdominal cavity

Methodology with function definition

The second name for Ultrasound of the gallbladder using functional tests is dynamic echo-cholescintigraphy or examination with a choleretic breakfast. The method allows you to determine the ability to contract the gallbladder at the present moment.

Upon completion of the first part of the examination, carried out on an empty stomach, the patient eats a test breakfast consisting of fatty foods - two egg yolks, 200-250 grams of sour cream or cottage cheese. You can also replace food intake with a sorbitol solution, which has choleretic properties.

Then the inspection is carried out 3 times - after 5 minutes, 10 and 15.

Study of ducts with removed gallbladder

Dynamic echo-choledochography - ultrasound of the ducts in the absence of a bubble is similar to the previous technique. First, the diagnostician assesses the structure, condition and lumen of the duct on an empty stomach, and then the patient is offered a food load (sorbitol solution).

Finally, 2 repeated examinations are carried out at an interval of 30 minutes after the food load.

During the procedure, the diagnostician records in the examination protocol the patient’s complaints about the occurrence of pain, and their characteristics - intensity, increase, duration or absence.

Interpretation of results

During the examination, the diagnostician evaluates the functional state and parameters of the organ, such as size, shape, location, mobility, and wall thickness.

The contractility of the bladder, the presence of polyps, stones and oncological processes are also determined.

Interpretation of Ultrasound of the gallbladder consists of a correlation and description of the norm of the organ being studied, and in the presence of pathological conditions.

The normal sizes of an organ are:

• length 7–10 cm;
• width 3–5 cm;
• transverse size 3–3.5 cm;
• wall thickness up to 4 mm;
• volume 30–70 cubic meters cm;
• diameter of the common duct is 6–8 cm;
• the internal diameter of the lobar ducts is up to 3 mm.

In this case, the bladder normally has the shape of an oval or pear, its contours are well defined and its bottom can extend 1–1.5 cm from under the liver.

Diagnostics shows almost all diseases of this organ known to medicine.

During the procedure, the diagnostician makes a conclusion about the presence of one or another type of pathology based on the complex of symptoms present.

Chronic cholecystitis is characterized by a decrease in the size of the organ, an increase in the density and thickness of the walls, a violation of their structure, unclear and blurred contours, and the presence of small inclusions in the lumen. Dyskinesia is determined by a visible bending of the bladder, an increase in the density of the walls and an increase in their tone.

GSD on ultrasound image

Cholelithiasis (cholelithiasis) appears during an ultrasound examination as light-colored formations (calculi), which can change location when the body moves.

An echo shadow is determined behind the stone, since these structures are impenetrable to ultrasonic waves.

The disease is characterized by the presence of biliary sludge (sediment, bilirubin flakes), but it should be distinguished from the accumulation of pus or hematoma, since there are often no clear differences between them. In addition, the walls of the bubble are thickened and the contours are uneven.

In most cases, ultrasound does not detect small stones, and the conclusion about their presence is made by the expansion of the duct above the blocked area. Polyps look like round formations located on the wall of the organ.

Exceeding their diameter by more than 1 cm is considered dangerous, since in this case the neoplasm may be malignant.

If, during repeated examinations, rapid growth of the polyp is observed, then this is a sure sign of its malignancy.

Oncological diseases are diagnosed when tumors larger than 1–1.5 cm are detected, excessive wall thickening and disruption of the contours of the organ.

Congenital anomalies can manifest themselves in the form of agenesis - the absence of an organ or, conversely, its doubling, the presence of diverticula - protrusion of the walls.

Ectopic localization may also be detected - an atypical location of the bladder, for example, outside the abdominal cavity or between the diaphragm and the right hepatic lobe. All diagnosed pathological processes require careful monitoring over time.

Therefore, after the first diagnosis, as a rule, a repeat ultrasound is prescribed no later than 2-3 weeks.

Source: https://apkhleb.ru/uzi/zhelchnogo-puzyrya

Ultrasound diagnostics of the gallbladder

Diseases of the digestive system are among the most common in medicine. For this reason, not only high-quality treatment is necessary, but also diagnostics, which should not only be effective, but also accessible to a wide range of patients. And a method that satisfies all these needs is ultrasound examination (US).

Why ultrasound?

This type of diagnostics was chosen for several reasons:

• The first is his safety. Ultrasound is one of the safest methods; such ultrasonic waves, which are used in diagnostics, are absolutely safe for the human body. In this case, the gender and age of the patient does not matter. Anyone can perform the diagnosis without fear.
• The next one is its effectiveness. In diagnosing diseases of the abdominal organs, including the gallbladder, ultrasound shows itself very, very well. Although it is not very good at diagnosing pathologies of hollow organs, it is good at diagnosing diseases of the liver, spleen, pancreas, gall bladder, etc.
• The use of ultrasound allows you to avoid punctures of the skin, introducing contrast agents or anesthesia into the body. Thus, ultrasound of the gallbladder is absolutely painless and non-invasive (no introduction of anything into the body).

As mentioned above, the method must be accessible.

Ultrasound machines are available almost everywhere, and even if diagnostics are needed, where there is still no such device, then there are special models that can be carried.

In addition, an ultrasound scan of the gallbladder is also affordable for almost everyone, or you can get a referral for an examination and then the examination will be performed completely free of charge.

What does an ultrasound of the gallbladder show?

There are quite a lot of gallbladder diseases and almost all of them, even at an early stage of development, can be diagnosed by ultrasound.

• The first thing that comes to mind is cholelithiasis (GSD). The pathology occurs quite often, and its treatment often ends with removal of the gallbladder. However, a timely ultrasound of the gallbladder will save the organ, since in the early stages of the development of this disease, treatment can be conservative.
• Ultrasound will also be able to see sludge; in simple words, this is the initial stage of cholelithiasis, when the first signs of stone formation appear.
• Inflammatory diseases such as cholecystitis have not been spared by ultrasound. At the same time, on ultrasound of the gallbladder it is possible to distinguish acute from chronic. But it is worth understanding that in order to accurately determine whether chronic cholecystitis is present or not, other important examinations must be carried out.
• Pathologies such as polyps are also detected on ultrasound. These are peculiar neoplasms, which are mostly benign and do not pose a danger to the patient’s body. However, if the polyp is adenomatous, then there is a risk of malignancy (malignancy) of such a neoplasm.
• Speaking about tumors, it is worth remembering that ultrasound shows itself well as a method for diagnosing cancer. But in the future, of course, it will be necessary to perform a biopsy and other more complex examinations, since ultrasound performs, for the most part, the function of the method that is the first to detect various types of pathologies, “illuminating” the doctor with a further plan of examination or treatment.

Diagnosis is also performed in a number of diseases associated with congenital anomalies:

• Ultrasound of the gallbladder diagnoses such a rare pathology as agenesis of the gallbladder. With it, the gallbladder is completely absent. But this diagnosis must be confirmed by other methods; the most accurate is to see its absence during surgery.
• There are several other quite interesting pathologies. For example, an abnormal location of the gallbladder, a double gallbladder, as well as a more dangerous pathology - multiple septa. With this congenital disease, a picture characteristic of acute cholecystitis or polyps develops.

In addition to examining the gallbladder itself, an ultrasound of the bile ducts is also performed.

How to prepare for an ultrasound of the gallbladder

Before describing the preparation for an ultrasound scan of the gallbladder, it should be noted that the gallbladder is not examined in isolation, but only together with the organs of the abdominal cavity and retroperitoneal space. Next, let's look at what preparation for an ultrasound examination includes:

• A week before diagnosis, you must exclude alcohol and fatty foods from your diet, as well as foods that stimulate increased gas formation. Among them are:
  • fresh vegetables and fruits,
  • bakery,
  • legumes,
  • milk,
  • fresh bread,
  • etc.
• 3 days before the examination, the doctor will prescribe enzyme preparations (Pancreatin, Mezim, Creon, etc.), and he will set the dosage and frequency of use independently.
• In addition, it is still necessary to take carminatives, especially for those patients who suffer from increased gas formation. It is worth mentioning that they are not always prescribed. Already on the eve of diagnosis, in the evening, before 19-20 hours, you should have a hearty dinner, but under no circumstances eat fatty foods.
• There is no need to perform an enema, but you should have a bowel movement naturally, for example by taking a laxative. Most often, diagnostics are prescribed in the morning; there is no need to have breakfast, as this can lead to gas formation in the intestines. If the diagnosis is scheduled for a later time, then the fasting period should last about 8 hours.

How is an ultrasound examination of the gallbladder performed and the norm?

The diagnosis itself is quite simple. The patient lies down on the couch and a special gel is applied to his stomach. Then the doctor begins to move the sensor over the skin, examining the organ. Afterwards, the sonologist compares the obtained data on the gallbladder with ultrasound standards.

Norms for the size of the gallbladder according to ultrasound results:

• length 40 - 95 mm ;
• width 30 - 50 mm ;
• transverse size 30 - 35 mm ;
• wall thickness about 2 mm ;
• the diameter of the common bile duct is 6 - 8 mm ;
• the internal diameter of the lobar bile ducts is not more than 3 mm .

There is also an examination such as an ultrasound of the gallbladder with determination of function, which will provide even more information about the condition of the organ, but its implementation is different.

How is an ultrasound of the gallbladder performed to determine its function:

Functional or ultrasound of the gallbladder with determination of function by duration of time takes about one hour. The first study is carried out on an empty stomach, and then with a choleretic breakfast.

This breakfast usually includes two egg yolks (raw or boiled). Yolks can be replaced with 250 gr. high-fat sour cream, cottage cheese or cream.

The ultrasound examination of the gallbladder itself with a load is carried out in 3 stages:

• The first in 5–10 minutes;
• Second in 20 minutes;
• The third in 40–45 minutes.

Functional ultrasound is performed in various positions. Most often, the person being examined lies on his side or back, but sometimes the doctor may ask you to stand up or sit down.

The doctor, as in the first case, applies a special gel to the device’s sensor, which is necessary for the study. The examination itself, as in the first case, is absolutely painless.

There are no contraindications for this research method. It is performed on both adult patients and children.

Thanks to its safety, simplicity and effectiveness, ultrasound has become one of the leading types of diagnostics not only in gastroenterology. But we should not forget about other important methods that will clarify and complement the diagnosis.

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Source: https://uzipro.ru/uzi-zheludochno-kishechnyiy-trakt/ultrazvukovaya-diagnostika-zhelchnogo-puzyrya.html

Ultrasound of the gallbladder

Medical center » Diagnostics » Ultrasound » Ultrasound of the gallbladder

Time: 10-20 minutes. Preparation for the examination: required. Presence of contraindications: none. Restrictions: none. Preparation of the conclusion: 10-15 minutes. Cost of the study: from 1,050 rubles. Ultrasound examination of the gallbladder at SM-Clinic is a non-invasive diagnostic method that provides accurate information about the condition of the organ and bile ducts. The study is usually performed in conjunction with an ultrasound of the abdominal organs. It is often prescribed in combination with liver ultrasound. Ultrasound is prescribed by a gastroenterologist if the following indications exist:

• frequent pain in the right hypochondrium that cannot be relieved with painkillers;
• heaviness, discomfort in the liver area;
• bitterness in the mouth;
• icteric color of the skin and mucous membranes;
• long-term use of medications;
• severe violation of the diet: irregular diet, excessive consumption of smoked, fried, spicy foods or addiction to low-calorie diets;
• abnormal test results for bilirubin, AST, ALT;
• biliary dyskinesia;
• cholelithiasis;
• traumatic lesions of the abdominal cavity;
• poisoning of the body;
• monitoring the state of the biliary system in the presence of oncological processes or suspicion of them;
• obesity of various stages;
• monitoring the effectiveness of prescribed therapy.

Patients whose gallbladder has been removed undergo a special type of examination - echo-choledochography, that is, ultrasound of the ducts with a food load. Ultrasound is not performed only if there are severe skin lesions in the area being examined, such as:

• burns;
• infectious lesions;
• wounds.

There are no other contraindications. Preparation for ultrasound diagnosis of the gallbladder includes a range of mandatory activities, including:

• Diet. 2-3 days before the examination, avoid alcohol, fatty foods, and foods that stimulate gas formation.
• Take enzyme preparations with meals three times a day.

On the eve of the study, you must have dinner no later than 19:00, including light but satisfying foods, such as oatmeal with water without sugar. It is also important to have a bowel movement. In the morning, if the ultrasound will take place before lunch, you cannot have breakfast. If the study is scheduled for the afternoon, a light breakfast is allowed, such as a glass of tea and a cracker. It is important that at least 6 hours pass between the last meal and diagnosis. Drinking water is prohibited 2-3 hours before the test. Ultrasound of the gallbladder is performed using an external sensor, which is moved along the anterior abdominal wall. The patient lies on his back, frees the upper abdomen from clothing. A water-soluble gel is then applied to the sensor, which improves the conductivity of ultrasonic waves. When the base of the organ is covered by intestinal loops, the patient may be asked to take a deep breath while holding his breath or roll over onto his left side. To identify stones or sand in the organ, the patient may be asked to stand and then lean forward several times. Ultrasound of the gallbladder with determination of function - dynamic echocholescintigraphy - is carried out according to a slightly different principle. First, the organ is examined on an empty stomach, then the patient is given a test breakfast consisting of 2 egg yolks and 250 g of sour cream or cottage cheese, after which the diagnosis is made three times - with an interval of 5, 10 and 15 minutes. You must stop eating and drinking 4-5 hours before. If the gallbladder is removed, then eating and drinking is allowed. When performing an X-ray with the introduction of contrast, ultrasound diagnostics are recommended to be performed after 3 days. Without contrast, ultrasound after x-ray is not contraindicated. Failure to comply with these recommendations may negatively affect the quality of the study. At SM-Clinic, ultrasound examinations of the gallbladder are performed by highly qualified diagnosticians with extensive practical experience. You can make an appointment for an ultrasound of the gallbladder and consultations in Moscow with SM-Clinic specialists, and also check the cost of the procedure with the call center operators.

Name of service	Price, rub.)*
Ultrasound of the gallbladder	1,050 rub.
Ultrasound of the gallbladder with color circulation	RUB 2,050
Ultrasound of the gallbladder with stress (3 studies)	2,400 rub.
Ultrasound of the abdominal organs and gall bladder with stress	RUB 3,950

We accept bank cards VISA, MASTERCARD, MAESTRO for payment

The full price list can be found at the reception desk or you can ask a question by calling +7 (495) 172-01-33.

* The administration of the clinic takes all measures to timely update the price list posted on the website, however, in order to avoid possible misunderstandings, we advise you to check the cost of services at the reception or in the contact center by phone +7 (495) 172-01-33.

The posted price is not an offer. Medical services are provided on the basis of a contract.

Source: https://www.smclinic.ru/diagnosis/ultrazvukovaya-diagnostika/uzi-zhelchnogo-puzyrya/

Ultrasound of the liver and gallbladder: preparation, conduct and results

Ultrasound examination of the hepatobiliary system provides valuable information about the condition of the internal organs. Ultrasound of the liver and gall bladder is a safe and painless study performed on a modern Siemens Acuson X300 PE device. It allows you to detect pathologies in a timely manner or ensure their absence.

Indications for liver ultrasound

Patients are referred for examination:

• with pain in the right hypochondrium;
• yellowness of the skin and sclera;
• injuries of the abdominal organs;
• suspected abnormalities in the structure of the gallbladder;
• abnormalities in blood tests indicating liver disease;
• acute and chronic diseases of the gallbladder and liver;
• chronic liver diseases;
• suspected tumors and metastases;
• long-term use of certain medications;
• alcohol abuse.

Preparing for an ultrasound of the gallbladder

The study is hampered by the accumulation of gases in the intestines. Therefore, 3–5 days before the ultrasound, you need to start preparing:

• correction of the diet (remove foods that cause increased gas formation - cabbage, yeast baked goods, brown bread, fruits, milk, carbonated drinks);
• fractional meals (small portions 3–4 times a day);
• limiting fluid intake - no more than 1.5 liters per day;
• taking enzyme preparations and adsorbents;
• if there is severe bloating or persistent constipation, the evening before the gallbladder ultrasound, you need to do a cleansing enema;
• You need to come for the study on an empty stomach, preferably in the morning;
• the break between diagnosis and the last meal is at least 8 hours.

When performing an emergency ultrasound of the gallbladder, no preparation is needed.

The examination cannot be carried out earlier than 2 days after esophagogastroduodenoscopy and an x-ray of the stomach with contrast, and no earlier than 3–5 days after laparoscopic surgery.

How is an ultrasound of the gallbladder performed?

The person lies down on the couch on his back, exposing his stomach. For better signal conductivity during an ultrasound, the doctor applies a special gel to the skin. Using the device's sensor, an examination is performed, starting from the area of ​​the right hypochondrium; if necessary, the entire abdominal area is scanned.

An ultrasound can also be performed lying on your left side. During the examination, the doctor may ask you to hold your breath and take several deep breaths. Scanning of the organ is carried out in three projections: longitudinal, transverse, oblique.

The gel is then removed using a napkin. The study takes about 20 minutes.

Results of ultrasound of the liver and gall bladder

Ultrasound examination of the hepatobiliary system can detect various types of disorders and diseases:

• traumatic lesions (gunshot wounds, open lesions, ruptures);
• inflammatory processes (hepatitis, abscesses, fatty hepatosis, alcohol damage, tuberculosis, syphilitic damage);
• tumors (cysts, nodes, malignant formations);
• fibrosis;
• vascular diseases;
• parasitic infestations;
• autoimmune disorders (cirrhosis, hepatitis, cholangitis);
• diffuse or structural and functional changes.

An ultrasound of the gallbladder can reveal:

• acute or chronic cholecystitis;
• gallbladder dyskinesia;
• cholelithiasis;
• gallbladder polyps;
• tumors.

Standards for liver ultrasound:

• homogeneity of structure;
• edge clarity and evenness;
• width - 23–27 cm;
• cross section - 20–22.5 cm;
• length - 14–20 cm;
• the diameter of the common hepatic duct is 3–5 mm;
• left lobe - 6–8 cm;
• right lobe - up to 12.5 cm;
• the diameter of the inferior vena cava is 15 mm.

During an ultrasound of the gallbladder, its parameters should not exceed:

• length - 7–10 cm;
• cross section - 3–3.5 cm;
• width - 3–5 cm;
• diameter of the common duct - 6–8 mm;
• wall thickness - up to 4 mm;
• the diameter of the lobar ducts is up to 3 mm.

In addition to assessing the condition of the liver, the study allows you to detect pathological changes in nearby organs, including the pancreas, kidneys, and intestines.

Contraindications

The study is carried out according to indications for patients of any age, including those with concomitant pathologies. The only contraindication is a burn or purulent damage to the skin.

In this case, during an ultrasound of the gallbladder, due to the pressure of the sensor and the application of the gel, the infection may begin to spread.

However, in emergency cases, for example, with acute pain in the hypochondrium, these restrictions are not taken into account.

It is advisable to monitor changes in the liver and bile ducts detected on ultrasound over time. After the first examination, the next one may be prescribed after 2-3 weeks.

Based on the diagnostic results, the patient is given a protocol with all the indicators and a medical report with the specified diagnosis.

Source: https://ndc-mrt.ru/diagnostika/uzi/uzi-pecheni-zhelchnogo-puzirya-kak-provoditsya/