Ultrasound Case Study: Diseases of the Bile Duct System

In this video, Prof. Dirk Becker, MD PhD shows you the different imaging positions when performing an ultrasound on the gallbladder and bile ducts.

-------------------------------------

Timestamps:

00:00 - Intro
00:10 - Examining the case of the 58-year-old with acute onset of abdominal pain
00:40 - Ultrasound image of gallbladder stones
01:21 - Viewing case 2 of gallbladder ultrasound
02:19 - Viewing case 3 of gallbladder ultrasound: severe inflammation
03:01 - Viewing case 4 of gallbladder ultrasound: dilatation of the common bile duct

Gallbladder stones are a common condition, and if there are stones in the gallbladder, they can lead to severe problems.

This video looks at four medical cases. In the first case, a 58-year old woman had an acute onset of abdominal pain and went to her primary care doctor. He detected that besides the normal gallbladder fluid, there were also masses in the gallbladder making a shadowing in the lower part of the ultrasound image. And when you see it in the video, it's clear that there are gallbladder stones.

She needed to go to a hospital for a surgical intervention, and the gallbladder had to be removed.

The next case can happen with or without stones. In the prior case, the gallbladder wall was still thin and there was no sign of inflammation in the gallbladder. But when stones are inside the gallbladder, the next clinical situation can occur, which is a severe inflammation of the gallbladder. And this is visualized by a thickening of the normally very thin wall of the gallbladder. And if this is a very acute onset, the thickening has a typical three-fold layer. It has an echo ridge echo poor, an echo rich layer, which is a sign of a severe inflammation.

Mostly this situation occurs with stones in the gallbladder, but it can also (although rare) occur without stones. When this situation is not detected because the patient didn't see a doctor - a primary care physician with a primary care ultrasound device - the situation can worsen and the whole gallbladder can fill with pus.

And the last case is the dilatation of the common bile duct. The normal common bile duct adjacent to the portal vein is very thin and sometimes cannot be visualized. In this case, you see the inferior vena cava, the portal vein, and the very thin common bile duct, as well as the dilatation of the common bile duct close to the portal vein. The reason for that is sometimes a stone and sometimes a mass in the pancreatic head, which blocks the normal fluid of the bile fluid.
-------------------------------------
Learn more about GE Healthcare handheld ultrasound: