{"id":348,"date":"2018-07-01t12:20:44","date_gmt":"2018-07-01t12:20:44","guid":{"rendered":"\/\/www.iolishoes.com\/?page_id=348"},"modified":"2021-01-07t22:25:22","modified_gmt":"2021-01-07t11:25:22","slug":"gallbladder-normal","status":"publish","type":"page","link":"\/\/www.iolishoes.com\/gallbladder-normal\/","title":{"rendered":"gallbladder normal"},"content":{"rendered":"\t\t
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<\/span>scan plane<\/span><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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normal scanning position to take advantage of using the liver as a window and displacing the bowel.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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a normal gallbladder should be thin walled (<3mm) and anechoic.it is a pear shaped saccular structure for bile storage in the right upper quadrant. its size varies depending on the amount of bile. fasted it will be approximately 10cm long.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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<\/span>gallbladder folds<\/span><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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folds are commonly seen and are normal.
make note if pathology such as calculi are contained within a compartment created by a fold.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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a phrygian cap is a specific, relatively common,inversion of the distal fundus of the gallbladder into the body.it may become adherent. it is an anatomic variant or acquired abnormality.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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the gallbladder wall is accurately measured anteriorly in a cross section. this is a transverse view.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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the gallbladder should be assessed with the patient standing to ensure any small stones or sludge are identified and if they are present determine if their mobility.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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scan protocol<\/h1>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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<\/span>role of ultrasound<\/span><\/h3>
  • \u00a0always tailor your scan to the clinical signs.<\/li>
  • always take a thorough history including previous cancer,diseases,blood results,family history and past surgery.<\/li>
  • perform an initial overall scan without imaging to get an idea what pathology there might be and how it might relate to the patients current complaint.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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    <\/span>limitations<\/span><\/h3>
    • often you will have problems with bowel gas overlying the gallbladder.<\/li><\/ul>

      ways to overcome this include :<\/p>

      • roll the patient into a left lateral decubitus or erect position.<\/li>
      • use the liver as a window especially when rolling the pt onto their left side<\/li>
      • deep inspiration \/ expiration<\/li>
      • distend the abdomen against the probe. (ask the patient to push their stomach out as if they are pregnant!)<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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        <\/span>patient preparation<\/span><\/h3>
        • fast for 6 hours. no food or drink.<\/li>
        • preferably book the appointment in the morning to reduce bowel gas.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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          <\/span>patient position<\/span><\/h3>
          • generally the gallbladder is best viewed in the left lateral decubitus position. however it\u00a0 can be viewed with the patient supine and erect.<\/li>
          • erect views may be useful to determine if stones are mobile or impacted in the neck.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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            <\/span>equipment setup<\/span><\/h3>
            • use the highest frequency probe to gain adequate penetration. this will be between a 2-7mhz range curved linear array or sector probe with colour doppler capabilities.<\/li>
            • start with 6mhz and work down to 2 or 3 for larger patients.<\/li>
            • assess the depth of penetration required and adapt.the gallbladder should be able to be scanned using a 7mhz as it is so superficial.paediatric and thin pts should be scanned with a 7mhz also.<\/li>
            • narrow the dynamic range<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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              <\/span>common pathology<\/span><\/h3>
              • folds<\/li>
              • phrygian cap<\/li>
              • polyp<\/li>
              • calculi<\/li>
              • sludge<\/li>
              • cholecystitis<\/li>
              • adenomyomatosis<\/li>
              • gallbladder carcinoma<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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                scanning technique<\/h1>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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                1. looking supine, left lateral decubitus and erect<\/li>
                2. use the liver as a window especially when rolling the pt onto their left side<\/li>
                3. measure the wall <3mm<\/li>
                4. is the gallbladder enlarged?>10cm in length<\/li>
                5. check with colour doppler for increased vascularity of the wall<\/li>
                6. assess the cystic duct,neck , body and fundus (sometimes there is a phrygian cap)<\/li><\/ol>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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                  <\/span>basic hardcopy imaging<\/span><\/h3>
                  • document the normal anatomy.<\/li>
                  • any pathology found in 2 planes, including measurements and any vascularity.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

                    scan plane normal scanning position to take advantage of using the liver as a window and displacing the bowel. a normal gallbladder should be thin walled (<3mm) and anechoic.it is a pear shaped saccular structure for bile storage in the right upper quadrant. its size varies depending on the amount of bile. fasted it will […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"tags":[],"class_list":["post-348","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages\/348","targethints":{"allow":["get"]}}],"collection":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/comments?post=348"}],"version-history":[{"count":0,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages\/348\/revisions"}],"wp:attachment":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/media?parent=348"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/tags?post=348"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}