What is cholelithiasis (gallstones) seen on ultrasound?

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From the Guidelines

Cholelithiasis seen on ultrasound means you have gallstones in your gallbladder, which can be accurately detected with an accuracy of 96% using ultrasound, as reported in a study published in the Journal of the American College of Radiology 1. When explaining this to a lay person, it's essential to understand that the gallbladder is a small organ under the liver that stores bile, helping digest fats. Gallstones are hard deposits formed when substances in bile crystallize. On an ultrasound, these stones appear as bright spots or shadows within the gallbladder and can vary in size. Some key points to consider include:

  • Many people with gallstones have no symptoms and don't require treatment.
  • If stones block the bile ducts, they can cause pain in the upper right abdomen, nausea, vomiting, or jaundice.
  • Treatment depends on symptoms; if experiencing pain or complications, surgery to remove the gallbladder (cholecystectomy) might be recommended, which is the most common treatment, as supported by the study 1.
  • The body can function normally without a gallbladder, as bile will flow directly from the liver to the small intestine.
  • Lifestyle changes, such as maintaining a healthy weight and eating a low-fat diet, may help manage mild symptoms but won't dissolve existing stones. It's also important to note that while ultrasound is highly accurate for detecting gallstones, its usefulness is limited in critically ill patients, where gallbladder abnormalities are common in the absence of acute cholecystitis, as mentioned in the study 1.

From the Research

What is Cholelithiasis

  • Cholelithiasis refers to the presence of gallstones in the gallbladder, which can cause symptoms such as abdominal pain, nausea, and vomiting.
  • Gallstones can be seen on ultrasound, a non-invasive imaging test that uses sound waves to create images of the gallbladder and bile ducts.

Ultrasound Findings

  • On ultrasound, gallstones appear as small, bright echoes within the gallbladder, often with acoustic shadowing behind them 2, 3.
  • The size, number, and location of gallstones can be assessed on ultrasound, which can help guide treatment decisions.

Treatment Options

  • Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive treatment that uses shock waves to break up gallstones into smaller pieces that can then pass out of the gallbladder 4, 5.
  • ESWL can be used in combination with oral bile acid therapy, such as ursodiol, to help dissolve the broken-up stone fragments and reduce the risk of recurrence 4, 6.
  • The effectiveness of ESWL and oral bile acid therapy can depend on factors such as the size and number of gallstones, as well as the patient's overall health.

Potential Complications

  • Potential complications of ESWL and oral bile acid therapy include biliary colic, diarrhea, acute cholecystitis, and acute pancreatitis 2, 3, 5.
  • The risk of these complications can be minimized by carefully selecting patients for treatment and monitoring them closely during and after treatment.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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