Fluid Around Gallbladder on Ultrasound

Fluid around the gallbladder on ultrasound can be caused by multiple conditions,  but raises concern for an inflamed gallbladder or cholecystitis.  Ultrasound of the gallbladder and right upper abdomen are often ordered when there is concern for gallbladder disease but also let’s us look at other structures around it.  Ultrasound is done by a technologist and a report is issued by a radiologist.

What does ultrasound of the gallbladder show?

Ultrasound is one of the best tests for the gallbladder.  We can see inside the gallbladder, it’s wall and anything around it.  Stones are the most common abnormality inside the gallbladder.  Sludge and polyps are some of the other common abnormalities.  We can see a thick gallbladder wall and fluid around the gallbladder.

What can cause fluid around the gallbladder?

Fluid around the gallbladder is most commonly seen with an inflamed gallbladder or cholecystitis.  This occurs when the gallbladder or it’s outflow into the bile duct is blocked by a stone.  The gallbladder becomes inflamed.  The wall thickens and fluid forms adjacent to the wall.   Usually patients have pain when pressure is applied to the gallbladder.

Fluid can form for other reasons as well.  One common one is when a patients has ascites in their abdomen.  Ascites can form form for many reasons but some of the more common ones include liver disease, heart failure and cancer.  In these cases, there can be small to large amounts of fluid, some of which is around the gallbladder.

Fluid around the gallbladder from ascites will usually not be associated with symptoms of gallbladder disease.  The gallbladder may otherwise be normal.  There will be more generalized ascites in the abdomen.  It can be tricky when the gallbladder also has other abnormalities like stones to distinguish from an inflamed gallbladder.

Inflammatory conditions in the abdomen can also cause fluid to track around the gallbladder.  One example is pancreatitis where fluid can track to the gallbladder.   Often the fluid will be centered around the pancreas and the blood work will be compatible with pancreatitis.   Fluid can also track to the gallbladder from some kidney disorders like infection or a stone which blocks the kidney.

Fluid around the gallbladder therefore can have multiple causes.  It does not always mean that the gallbladder is inflamed.  Fluid can form from diseases that cause ascites or fluid.  Fluid can also form around the gallbladder from inflammatory diseases of nearby organs.  Both the clinical and imaging findings will often give clues as to whether the fluid around the gallbladder is from gallbladder disease or from some other cause.