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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.
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.
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.
[1] [26] [27] Ultrasound findings suggestive of acute cholecystitis include gallstones, pericholecystic fluid (fluid surrounding the gallbladder), gallbladder wall thickening (wall thickness over 3 mm), [28] dilation of the bile duct, and sonographic Murphy's sign. [13]
Ultrasound findings may show thickened gall bladder wall, tiny anechoic spaces (Rokitansky–Aschoff sinuses or RAS), and twinkling artifact (or comet-tail reverberation). Comet tail reverberation, which is due to reflections from cholesterol crystals, is a highly specific sign for adenomyomatosis.
The first is how often and how well the gallbladder contracts; incomplete and infrequent emptying of the gallbladder may cause the bile to become overconcentrated and contribute to gallstone formation. This can be caused by high resistance to the flow of bile out of the gallbladder due to the complicated internal geometry of the cystic duct. [36]
Sometimes gallstones may get stuck in the cystic duct, which serves as a bridge between the gallbladder and the common bile duct, and can lead to inflammation in the wall of the gallbladder. [11] This inflammation of the gallbladder is known as cholecystitis and is a common indication for surgical removal of the gallbladder, or cholecystectomy ...
Gallbladder: Wall thickening: 3 mm wall thickness [5] Hydrops: Greater than 5 cm transverse dimension [6] Heart: Cardiomegaly: Medical imaging: Indicated by cardiothoracic ratio over 0.5. [7] Autopsy: Cardiomegaly has been suggested when the heart weighs more than >399 grams in women and >449 grams in men. [8] Large intestine: Dilation