Biliary Jr
Biliary Jr
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14 year old patient found to have large gallstone. Shown here is long axis view of the gallbladder, notice the shadowing present from the gallstone as the probe is fanned.
Kathryn Pade, MD
Healthy 13 year old presented with 2 days of epigastric and RUQ pain, with tenderness in the RUQ on exam. Biliary POCUS was performed with a low frequency, curvilinear transducer. She had a positive Murphy's sign. In the transverse view, the gallbladder is demonstrated with a thickened wall and with adjacent hypoechoic collections suggestive of pericholecystic fluid. She underwent ERCP, was found to have a common bile duct stone, and ultimately went for cholecystectomy.
Contributor: Allie Grither, MD, St. Louis Children's Hospital (Washington University in St. Louis), @AGPemMD
16 y/o F with RUQ pain. POCUS shows a thickened gallbladder wall. In the appropriate setting this could be consistent with cholecystitis though thickening of the gallbladder wall can also be a normal finding following eating a meal.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
17 yo M with epigastric and right upper quadrant pain. Unable to tolreate PO. POCUS shows a thickened gallbladder wall with cholelithiasis consistentw tih cholecystitis.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
15 yo presents with abdominal pain. POCUS shows a gallbladder polyp of unknown significance, likely incidental finding.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
16 yo with abdominal pain. Normal gallbladder in long axis.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
Normal Anatomy
16 yo with abdominal pain. Normal gallbladder in long axis.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
16 yo with abdominal pain. POCUS shows a normal gallbladder in short axis.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
15 y/o with epigastric abdominal pain. POCUS shows a normal gallbladder with a normal gallbladder wall measurement.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
Cholelithiasis
14 year old patient found to have large gallstone. Shown here is long axis view of the gallbladder, notice the shadowing present from the gallstone as the probe is fanned.
Kathryn Pade, MD
15 year old with right upper abdominal pain
No other history
On examination, tenderness over right upper/rebound tenderness as well
USG abdomen revealed the above image
Contributor: Dr Vanitha American Mission Hospital
13 y/o M with abdominal pain. POCUS shows gallbladder sludge.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
Cholecystitis
Healthy 13 year old presented with 2 days of epigastric and RUQ pain, with tenderness in the RUQ on exam. Biliary POCUS was performed with a low frequency, curvilinear transducer. She had a positive Murphy's sign. In the transverse view, the gallbladder is demonstrated with a thickened wall and with adjacent hypoechoic collections suggestive of pericholecystic fluid. She underwent ERCP, was found to have a common bile duct stone, and ultimately went for cholecystectomy.
Contributor: Allie Grither, MD, St. Louis Children's Hospital (Washington University in St. Louis), @AGPemMD
16 y/o F with RUQ pain. POCUS shows a thickened gallbladder wall. In the appropriate setting this could be consistent with cholecystitis though thickening of the gallbladder wall can also be a normal finding following eating a meal.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
17 yo M with epigastric and right upper quadrant pain. Unable to tolreate PO. POCUS shows a thickened gallbladder wall with cholelithiasis consistentw tih cholecystitis.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
Common Bile Duct Pathology
11 year old female with abd pain and emesis. Kicked in stomach by horse 6 weeks prior with grade 4 liver lac. Seen a few days ago with reassuring labs and US. Now with rising aminases and bilirubin. POCUS demonstrated a dilated and edematous gallbladder with sludge, and a dilated CBD and the classic 'double barrel' sign.
Contributed by: Matthew Moake, MD PhD
11 year old female with abd pain and emesis. Kicked in stomach by horse 6 weeks prior with grade 4 liver lac. Seen a few days ago with reassuring labs and US. Now with rising aminases and bilirubin. POCUS demonstrated a dilated and edematous gallbladder with sludge, and a dilated CBD and the classic 'double barrel' sign.
Contributed by: Matthew Moake, MD PhD
11 year old female with abd pain and emesis. Kicked in stomach by horse 6 weeks prior with grade 4 liver lac. Seen a few days ago with reassuring labs and US. Now with rising aminases and bilirubin. POCUS demonstrated a dilated and edematous gallbladder with sludge, and a dilated CBD and the classic 'double barrel' sign.
Contributed by: Matthew Moake, MD PhD
Other Pathology
Healthy 13 year old presented with 2 days of epigastric and RUQ pain, with tenderness in the RUQ on exam. Biliary POCUS was performed with a low frequency, curvilinear transducer. She had a positive Murphy's sign. In the transverse view, the gallbladder is demonstrated with a thickened wall and with adjacent hypoechoic collections suggestive of pericholecystic fluid. She underwent ERCP, was found to have a common bile duct stone, and ultimately went for cholecystectomy.
Contributor: Allie Grither, MD, St. Louis Children's Hospital (Washington University in St. Louis), @AGPemMD
16 y/o F with RUQ pain. POCUS shows a thickened gallbladder wall. In the appropriate setting this could be consistent with cholecystitis though thickening of the gallbladder wall can also be a normal finding following eating a meal.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
15 yo presents with abdominal pain. POCUS shows a gallbladder polyp of unknown significance, likely incidental finding.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego