Gallbladder Stones on Ultrasound

An ultrasound of the gallbladder is a commonly ordered test when you have pain that your doctor believes originates from the gallbladder. The gallbladder is in the right upper abdomen by the liver. The gallbladder stores bile which helps you digest foods. Most commonly, stones causes biliary colic which is an abdominal discomfort particularly after a fatty meal. Some patients have no symptoms at all. Others may develop acute cholecystitis which is a an inflamed gallbladder which requires surgery.

An ultrasound of the gallbladder will be ordered which is the best test to look at the gallbladder and it’s contents. Ultrasound is excellent at detecting stones. Ultrasound is better than a CT or MRI. Gallstones will look white and cast a shadow behind them. In medical speak you may see the radiologist refer to them as simply stones or describe them as highly echogenic with acoustic shadowing. Gallstones on ultrasound will also often move in position as the technologist moves your body. This also distinguishes the, from fixed abnormalities like masses and polyps. Stones on ultrasound can range from barely visible to centimeters in size.

The good thing about a gallbladder ultrasound is that you can also tell if the gallbladder is inflamed. In some of these cases, we will see a thick wall, fluid around the gallbladder, and pain when the technologist applies pressure over the gallbladder with the ultrasound probe. Other organs in the right upper abdomen will also be imaged in case there are any other problems or complications.

Another dangerous complication of gallstones is that they can pass into the bile duct. The bile duct is a thin tube that runs from your liver to the duodenum which is the first part of your small intestine. Bile is made by the liver and passes into the intestine to help you digest foods. The gallbladder stores the bile and concentrates it. The gallbladder is connected to the bile duct. When a stone passes into the bile duct from the gallbladder, a blockage may occur which will lead to pain, potential infection and possible pancreatitis or an inflamed pancreas. The ultrasound may not see the passed stone but may show a widened bile duct.

Gallstones are therefore potentially dangerous in that they can cause life threatening conditions such as a blocked bile duct, inflamed pancreas, infection of the bile duct or cholangitis and an inflamed gallbladder or cholecystitis. It is therefore important to get a surgical consult if you have gallstones, particularly if they are causing you problems.