June 2018

Is it a polyp or something else?

Clinical Info

Middle age female patient Examined for SONOZORG A primary care ultrasound facility.
Incidental finding.

Wat would you do?
A) Do a CT scan
B) Use color doppler
C) Turn the patient
D) Send the patient to the surgeon

Ultrasound Images & Clips

Is it a polyp or something else? What would you do

If you look carefully you can see a small layer of thick bile
If you look carefully you can see a small layer of thick bile
Transverse image If you look carefully you can see a small layer of thick bile.
If you use the color doppler you would not see any flow but does that exclude a polyp?
A CT scan is expensive and the surgeon is a bit premature and in this case unnecessary
Transverse image If you look carefully you can see a small layer of thick bile. If you use the color doppler you would not see any flow but does that exclude a polyp? A CT scan is expensive and the surgeon is a bit premature and in this case unnecessary
After turning the patient on his left side the lesion moves and changes form and finally disappears
After turning the patient on his left side the lesion moves and changes form and finally disappears
After turning the patient on his left side the lesion moves and changes form. So the lesion proved to be sludge
After turning the patient on his left side the lesion moves and changes form. So the lesion proved to be sludge
This is a second patient with a large sludge ball
This is a second patient with a large sludge ball
This is another patient with a large sludge ball
This is another patient with a large sludge ball
This lesion also looks like it could be a polyp, but watch out when you use color doppler
This lesion also looks like it could be a polyp, but watch out when you use color doppler
Not every color doppler signal means flow like in this case
Not every color doppler signal means flow like in this case

Conclusion

The lesion proved to be sludge or thick bile If you see something in the gallbladder and you don't know if it is sludge or a polyp first tun the patient. If the lesion doesn't move or change form use the color doppler. If there is flow and the lesion is larger than 1 cm, always send the patient to the surgeon. In those cases the surgeon will order a CT scan to check for metastases and invasive growth because of the possibility of malignancy.
If the lesion is smaller at least do a control examination to check for growth


Details

  • Sex: Female
  • Body part: Gallbladder

Created with

  • Hitachi Ultrasound System