
Ultrasonic anatomy Located inferior to rt. Lobe of liver
Long axis 6-12 cm , short axis 3-5 cm (4*10cm usually at fasting )
Contracted < 5 cm
Distended > 12 cm when the patient is fasting
Max normal diameter of CBD=4 to 7 mm
Wall Thickness:
Measured in the side in contact with the liver.usually < 3 mm.
From 3-5 mm >>> suspect thick wall
More than 5 mm >>> It is a thick wall gall bladder which is seen in:
Cholecystitis (acute-chronic).
Hepatitis ( viral).
Common Bile Duct is anterior to portal vein.this is the position of porta hapatis
Imaging technique
-overnight fast(6-12hr) to distent GB and remove gas shadow
Short focal length transducer is better as GB is anteriorly located organ.
Supine ,LPO position for imaging
Ganarally dilated bile duct seen in longitudional scan.portal vein ant. To IVC
Contents
Stones:
seen inside, mobile except at the neck they appear white with posterior shadow.
Thick bile.
Called sludge.Change with changing position. The picture occurs in the presence of thick bile in patients on IV fluids for 3-4 days and in inflammation.
Parasite:
Fasciola appears pearl shape.
Move as a whole.
Cancer & polyps:
Polypoidal or heterogeneous mass.


Pathologies
CHOLELITHIASIS-gall stone have high reflictive echo with prominent acoustic posterior shadow
Gravity dependent movement confirms diagnosis
Wall thickening as a hypoechoeic region b/n two echoeic lines,suggest chr.cholecystitis,alcoholism.
Sludge
No acoustic shadow
Low to mild level echoes
Moves very sluggishly
Acute cholecystitis
Associated with cholelithiasis in most cases
Gall stone with focal GB tenderness,usg MURPHY s sign
Pericholecystic edema
Wall edema or wall hypoechoeic
Sometime stone may not be present ,called acalculus cholecystitis eg.burns,old age,after major trauma,and fasting patient
Intrahepatic bile duct
If bile duct are >2mm dia
Second ultrasonic feature of bile duct dilatation is irregularity of bile duct dilatation
Extrahapatic bile duct
Normally 4mm at age 40,5mm at 50
Common site at head of pancrease when double duct sign may be seen
Cbd seen by parasagittal scan
Other facts
Fluid filled colon may appear like GB,wait and watch peristalsis.
In bed ridden ,numerous mass,sludge is not pathological
Polyps donot produce posterior shadow
In obese,difficult to see GB from subcostal approach
mbbs in Philippines
ReplyDeleteEvery year, almost 8000 foreign students take admission in Philippines Medical universities and out of which around 50% are Indian students. The standard of education in Philippines universities is well known around the world. Thousands of doctors from these medical universities are sent to various countries like USA and UK every year. There are around 2299 higher educational institutions and 40 medical colleges. The main benefits of pursuing MD degree from
Top Medical Colleges in Philippines :
EMILIO AGUINALDO COLLEGE OF MEDICINE
UNIVERSITY OF PERPETUAL HELP SYSTEM DALTA
LYCEUM NORTHWESTERN UNIVERSITY
DAVAO MEDICAL SCHOOL FOUNDATION
SOUTHWESTERN UNIVERSITY
Top Searched Topics on MBBS in Philippines
study mbbs in philippines
philippines medical colleges list
best medical colleges in philippines for indian students
philippines medical colleges
best medical colleges in philippines
mci approved medical colleges in philippines
for more information contact us : +91 90329 55688
UV GULLAS COLLEGE OF MEDICINE is one of Top Medical College in Philippines in Cebu city. International students have the oppertunity to study medicine in phillipines at affordable cost and world class University. The college has successful alumni who have achieved well in the fields of law, business, politics, academe, medicine, sports and other endeavors. At University of the Visayas, we prepare students for a global competition.
ReplyDeleteDirect MBBS Admissions Open: 2020-21
Mobile No: +91 90329 55688
Apply Now: https://www.careerplus.org.in/philippines-medical-college/uv-gullas-college-of-medicine
MBBS in Philippines Wisdom Overseas is authorized India's Exclusive Partner of Southwestern University PHINMA, the Philippines established its strong trust in the minds of all the Indian medical aspirants and their parents. Under the excellent leadership of the founder Director Mr. Thummala Ravikanth, Wisdom meritoriously won the hearts of thousands of future doctors and was praised as the “Top Medical Career Growth Specialists" among Overseas Medical Education Consultants in India.
ReplyDeleteWhy Southwestern University Philippines
5 years of total Duration
3D simulator technological teaching
Experienced and Expert Doctors as faculty
More than 40% of the US returned Doctors
SWU training Hospital within the campus
More than 6000 bedded capacity for Internship
Final year (4th year of MD) compulsory Internship approved by MCI (No need to do an internship in India)
Vital service centers and commercial spaces
Own Hostel accommodations for local and foreign students
Safe, Secure, and lavish environment for vibrant student experience
All sports grounds including Cricket, Volleyball, and others available for students