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Gallstones can vary in size and shape from as small as a grain of sand to as large as a golf ball. [39] The gallbladder may contain a single large stone or many smaller ones. Pseudoliths, sometimes referred to as sludge, are thick secretions that may be present within the gallbladder, either alone or in conjunction with fully formed gallstones.
The gallbladder has a capacity of about 50 millilitres (1.8 imperial fluid ounces). [2] The gallbladder is shaped like a pear, with its tip opening into the cystic duct. [4] The gallbladder is divided into three sections: the fundus, body, and neck. The fundus is the rounded base, angled so that it faces the abdominal wall.
Adenomyomatosis describes a diseased state of the gallbladder in which the gallbladder wall is excessively thick, due to proliferation of subsurface cellular layer. It is characterized by deep folds into the muscularis propria. Ultrasonography may reveal the thickened gallbladder wall with intramural diverticulae, called Rokitansky-Aschoff sinuses.
Although unusual, it is possible to have a common bile duct stone despite prior cholecystectomy. One study found that in patients diagnosed with choledocholithiasis, 28% had undergone prior cholecystectomy. Such stones are thought to be the result of stones missed at the time of the cholecystectomy, as opposed to the formation of new stones. [3]
Human gallstones, all removed from one patient. Grid scale 1 mm. Calculi in the inner ear are called otoliths; Calculi in the urinary system are called urinary calculi and include kidney stones (also called renal calculi or nephroliths) and bladder stones (also called vesical calculi or cystoliths).
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Gallbladder: No stones, wall thickening, or pericholecystic fluid. Common Bile Duct: Nondilated measuring 1.3 mm at the level of the porta hepatis. Pancreas: Visualized portions unremarkable. Spleen: Normal in size. Kidneys: Right and left kidneys measure 11.5 cm and 12 cm in length respectively. No hydronephrosis.
It shows a gallbladder wall that is almost pathologically thickened, at 3 mm. However, there is no apparent edema in the pericholecystic fat. The gallbladder contains biliary sludge, as well as gallstones, which create acoustic shadowing. There is thus gallstones without current cholecystitis.