Pericholecystic fluid
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
Thick gallbladder wall
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
Thickened gallbladder wall with stones
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
Gallbladder polyp
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
Normal gallbladder
16 yo with abdominal pain. Normal gallbladder in long axis.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
Cholelithiasis
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
Normal Gallbladder, Short Axis
16 yo with abdominal pain. POCUS shows a normal gallbladder in short axis.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
Normal Gallbladder Wall Measurement
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
Normal Gallbladder Measurements
Normal gallbladder measurements in a 3 year old male.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
Normal Common Bile Duct Measurement
Normal common bile duct measurement.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
Gallbladder Sludge
13 y/o M with abdominal pain. POCUS shows gallbladder sludge.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
Cholelithiasis with Stone in Neck
15 y/o M with RUQ pain, found to have cholelithiasis without cholecystitis.
Contributor: Kathryn Pade, MD, Rady Children's Hospital San Diego
Dilated Common Bile Duct - B-Mode (1/3)
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
Dilated Common Bile Duct - Color Doppler (2/3)
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
Dilated Common Bile Duct - Measurement (3/3)
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
