GI Radiology > Biliary > Gallbladder > Inflammatory > Cholelithiasis

Inflammatory Diseases of Gallbladder

Cholelithiasis

  1. Pathogenesis:
  • May occur when cholesterol levels are high. Normally, bile salts and lecithin are sufficient to keep the cholesterol soluble.
     
  • Approximately 80% of stones are lucent cholesterol and 20% contain enough calcium to be detected on radiograph.
     
  • Gallstones are more common in women and in patients with pancreatitis, cirrhosis, diabetes, Crohn's disease, hyperparathyroidism, and hemolytic anemia.
     
  • Stones are freely moveable and may float in the gallbladder depending on their density.
     
  1. Radiographic findings:
  • U/S: all gallstones will show a bright intraluminal echo and cast a posterior shadow when imaged under the appropriate conditions and with the correct transducer settings.
  • Small stones (< 5mm) will likely have to be imaged with a high frequency transducer to observe shadowing.
     
  • In approximately 20% of cases, the gallbladder will be completely filled with stones. In such a case, the gallbladder will demonstrate a bright echo with posterior shadowing.
     
 

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