Ultrasound examination (ultrasound) of the gallbladder

An ultrasound examination of the gallbladder is a non-invasive diagnostic procedure in which the organ can be visualized using high-frequency sound waves. The procedure is completely safe and painless.

Ultrasound of the gallbladder is rarely performed separately, as a rule, the area of ​​uXNUMXbuXNUMXbthe entire abdominal cavity is examined, with a study of the liver, bile ducts, pancreas and spleen.

Classification of techniques

Traditionally, patients undergo a standard ultrasound examination, which is not particularly time consuming, providing extended results. The most important advantages of this method include its harmlessness, due to which the study is possible for children under one year old and pregnant women.

The procedure does not carry radiation exposure, as is the case with other modern diagnostic methods, in particular, computed tomography or radiography.

In the absence of a primary diagnosis, in the event of discomfort or other symptoms in the abdominal cavity, the patient is recommended to undergo an ultrasound scan of all organs localized in it.

With a diagnosed chronic gastrointestinal disease, it is possible to conduct an ultrasound scan of a specific organ.

If necessary, according to the results obtained, to confirm or refute a particular disease, they resort to more accurate studies performed on magnetic resonance or computed tomography.

For most potential patients in the gastroenterology department, a simple ultrasound is sufficient, which involves the use of a standard device along with a highly sensitive sensor. For better contact of the signal transducer with the skin during the study, a special gel is used. It does not cause an allergic reaction and is safe even for people with sensitive skin.

To prepare for the procedure, it is necessary to take care of comfortable clothing in advance to ensure access to the study area. During the procedure, the diagnostician, using a sensor, contacts the organs through the abdominal wall, and the reflected ultrasonic waves are displayed on the monitor.

With ultrasound of the bottom of the gallbladder, intestinal loops can close it. To improve the view, you will need to take a deep breath, followed by a breath hold. Next, the patient rolls over to the left side to open the organ from a different viewing angle.

If necessary, check the functional capacity of the gallbladder, perform an ultrasound with a load on the gallbladder. In this procedure, after an ultrasound scan on an empty stomach, the patient is offered a choleretic breakfast, consisting of sour cream 20-25% fat, cream or a sandwich with butter. This fat load contributes to the synthesis of bile, and the contractility of the gallbladder will be visible during the study.

Dynamic echo-choledochography

A similar procedure with a choleretic breakfast to assess the functional activity of the common bile duct – common bile duct. After holding a time interval of half an hour after breakfast, the examination is carried out again to determine the resulting difference in tone.

At the same time, all incoming complaints of the patient regarding:

• the intensity of pain attacks;
• features of the disease state;
• increase in pain impulse;
• seizure duration.

Indication for appointment

It is a mistake to believe that gallbladder dysfunction occurs exclusively in adults. A significant percentage of children are born with a congenital anomaly of development – an inflection of the gallbladder, which is manifested by biliary dyskinesia (BD) in the form of pain and indigestion.

The attending specialized doctor, a gastroenterologist, directs the ultrasound procedure.

Based on his experience, the gastroenterologist will definitely clarify whether the patient has recently been disturbed by the following symptoms:

• periodic pain in the right hypochondrium, which is not stopped by traditional antispasmodic drugs, cannot be removed;
• discomfort in the liver;
• bitterness in the mouth;
• incomprehensible yellowness of the skin all over the body, as well as on the mucous membranes.

Another fundamental issue concerns the individual eating habits and lifestyle of the patient. If he maliciously violates the rules of a healthy diet, then sooner or later this will negatively affect the functional ability of the gallbladder.

The key points in violating proper rational nutrition are the use of too spicy, fatty, smoked, fried foods, irregular meals, including the frequent use of dry meals, the use of purely low-calorie low-fat foods, in order to reduce weight.

The last point is especially important for people who exclude high-calorie foods from the daily menu based on diets for quick weight loss. Normally, you should alternate different foods so that the gallbladder has time to cope with its functional duties.

Also, the cause of dysfunction of the biliary system may be the use of certain drugs, without taking into account their possible side effects.

Occasionally, the reason for referral to an ultrasound procedure is the results of a biochemical blood test, namely, an increase in the level of liver and bile enzymes.

It is necessary to regularly conduct such a study in patients who have previously had diseases of the biliary tract and gallbladder, such as cholelithiasis, biliary dyskinesia, confirmed neoplasms of a malignant or benign nature, and obesity.

In case of injuries of the abdominal cavity, severe intoxication of any origin, including alcohol, it is also necessary to consult a doctor.

According to the protocol, before prescribing or choosing hormonal contraceptives, you will also have to undergo a similar examination. It is especially important not to ignore the issued referral for women who have a predisposition to gallbladder dysfunction.

The reason is that oral contraceptives are often a catalyst for the rapid formation of stones. For the same reason, they often become an impetus for triggering the inflammatory process in the gallbladder. It is not for nothing that such diseases are a relative contraindication for taking hormonal contraceptives.

It is important to arrange regular monitoring if treatment has been previously prescribed. And we are talking not only about testing the effectiveness of alternative treatment, but also after surgery.

Against the background of many indications, contraindications seem completely insignificant. We are talking about significant damage to large areas of the skin of the abdominal cavity. This may be a deformity after an open wound or an extensive burn. No other significant restrictions were noted.

Proper preparation

Unlike the use of ultrasound for most other internal organs, gallbladder evaluation takes several days to properly prepare. The principle of how to prepare for manipulation remains the same for all hollow organs located in the abdominal cavity.

You should start with a diet. A few days before the appointed date, the following must be excluded from the usual diet:

• fatty food;
• alcoholic beverages;
• grain bread and other yeast baked goods;
• raw fruits, berries, vegetables;
• dairy products;
• beans;
• carbonated drinks;
• strong tea or coffee.

Instead, it is necessary to include in the diet cereals boiled in water, low-fat cottage cheese, boiled or steamed fish, lean meat or chicken, soft-boiled eggs.

During meals, it is important to follow your doctor’s recommendations for taking enzyme preparations or anti-gas medications.

Before the date of the procedure, the last meal should be no later than at seven o’clock in the evening. Dinner should be both light and satisfying. Also in the evening you will need to carry out a cleansing procedure for the intestines with an enema or a special

pharmaceutical agent with an identical effect.

If the inspection is scheduled for the first half of the day, then breakfast will have to be excluded. But if the procedure is carried out in the afternoon, then breakfast is still allowed, but it should be as light as possible. We are talking about a glass of not too strong tea and one cracker. In this case, the interval between eating and research should be at least six hours.

Also, before going to the ultrasound room, you should check with the doctor about the need to first cancel the medications taken, if any.

Do not smoke on the eve of manipulation or chew gum.

If you ignore the advice presented, then during the examination you can get distorted results, which will lead to the choice of erroneous treatment tactics.

Diagnosable diseases

Due to the ability of diagnostics to detail even minor anomalies, the method allows you to detect polyps and other abnormalities. Often, with the help of ultrasound, specialists diagnose the following diseases: acute, chronic cholecystitis, gallbladder dyskinesia, cholelithiasis.

There are differences between the acute and chronic stages of the course of cholecystitis, which are perfectly visible with the help of imaging. So, in the acute phase of the disease, the diagnostician will note the following problems with the gallbladder in conclusion: thickened walls of more than 4 mm, increased size, internal partitions, abnormally high blood flow in the cystic artery.

If the patient has symptoms indicating chronic cholecystitis, then the image will clearly show certain signs in the form of reduced sizes, thickening of the walls with deformations, fuzzy contours, small inclusions in the lumen.

Even a slight bending of the organ, which is accompanied by an increased tone of the walls with their subsequent compaction, may indicate dyskinesia.

A problem that significantly worsens the quality of life is cholelithiasis. However, it will not be possible to examine small stones with the help of a classic examination, no matter how highly sensitive the diagnostician is using a sensor.

The decoding for this disease provides for the following marks in the conclusion:

• small light formations that shift when changing positions;
• a dark area behind the stone, since the formations are not able to transmit ultrasonic pulses;
• sediment of bilirubin crystals;
• uneven contours and thickened wall.

Only an experienced diagnostician will be able to recognize sludge without confusing it with a condition characteristic of a hemorrhage or an accumulation of purulent fluid.

The presence of rounded formations on the walls of the bladder indicates the presence of polyps. In the future, it is necessary to monitor changes in the growth of the polyp during re-examination. If the formation develops very quickly, then this may indicate its malignancy.

Tumors may also be indicated by formations above the average of 1 cm, as well as deformation of the contours of the bladder along with thickening of the wall.

Congenital anomalies can be detected, among which even agenesis occurs, which is the complete absence of the gallbladder from birth. Sometimes in babies a non-standard location of the organ is fixed, or even a double bladder.

Based on the results of the examination, a decision is made on the final diagnosis, taking into account the results of other tests, as well as the patient’s current complaints.

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