Ultrasound of the gallbladder with a choleretic breakfast. How is an ultrasound of the gallbladder done with and without load: cost. How to prepare for research

Ultrasound of the gallbladder with the definition of function is the only non-invasive method that makes it possible to most accurately determine the condition of the organ. The advantages of this diagnosis are the high reliability and safety of the study.

Sound examination with function determination is carried out in real time by a line scan device.

This procedure allows you to extremely accurately determine the size and functional abilities of the body.

Most often, ultrasound is prescribed to determine biliary dyskinesia. This method allows you to identify five degrees of development of the disease.

In addition, the procedure can be recommended for:

cholecystitis;
stones;
cholecystocholangitis;
long-term medication;
frequent pain in the region of the right hypochondrium;
yellowness of the skin;
abdominal trauma;

dyskinesia;
chemical intoxication;
when malignancy is suspected.

During the procedure, the maximum size of the organ in transverse and longitudinal sections, its location, contractile capabilities, diameter of the ducts, and the presence of formations are determined. Subsequently, according to these indicators, the state of the walls and channels of the bubble is clarified.

The study is carried out in four stages. The first examination of the patient is done on an empty stomach, the second - after eating a choleretic breakfast, the third and fourth times the examination is done at intervals of 15 - 30 minutes.

The examination of the patient is carried out in two positions: the first time, when the person lies on his back, the second - on his side. If necessary, they can additionally carry out the procedure in a sitting and standing position.

If the gallbladder does not have any abnormalities, its indicators will be as follows:

length from seven to ten centimeters;
width from three to five centimeters;

size in diameter from three to three and a half centimeters;
volume from thirty to seventy cubic centimeters;
wall thickness does not exceed four millimeters;
the diameter of the common bile duct is in the range of six to eight millimeters.

In addition, the bile-sparing organ should have a pear-shaped or oval shape and clear contours.

Normal motility of the organ is confirmed if, forty minutes after the choleretic load, the bladder has decreased by sixty percent.

With all deviations from the above indicators, we can talk about the presence of the disease.

Preparation for the procedure

The main difference between the ultrasound of the bile-sparing organ with the definition of function from the usual examination is that this procedure allows you to evaluate functional change organ in dynamics.

It is carried out in a hospital and requires some preparation.

Stages of preparation for ultrasound:

A week before the examination, you should abandon vegetables, fruits, alcohol, milk, soy, bread, beans, cheese, peas, yeast baked goods. That is, from everything that contributes to gas formation.
Three days before the ultrasound, enzyme preparations and agents that reduce gas formation are prescribed.
In the evening before the procedure, only a light dinner is allowed, but no later than 20:00. It is best to cook unsweetened, lean porridge. If the patient suffers from constipation, it is necessary to use a laxative preparation twelve hours before the examination.

AT individual cases a cleansing enema is done before the ultrasound examination. But such an event is not necessary and is justified by the fact that during the procedure the intestines can obscure the bile-sparing organ.

Preparation for a functional examination of a child has its own nuances.

The doctor may not prescribe the use of enzyme preparations. In addition, babies are allowed to feed three hours before the procedure, three-year-olds - four, eight-year-old children - six.

Older children are trained in the same way as adults.

Ultrasound of the gallbladder helps to identify such diseases:

Acute cholecystitis. Ultrasound examination shows thickening of the walls, an increase in the size of the organ, multiple internal partitions, and increased blood flow in the bile artery.
Chronic cholecystitis. With this pathology, the size of the organ decreases, the walls thicken and deform, the contours in the image are fuzzy, there are small inclusions in the lumen.
Dyskinesia of the gallbladder. With such a disease, the doctor observes an inflection of the organ, thickening of the walls and an increase in their tone.

cholelithiasis. In the presence of gallstone pathology, the formations are displaced when the position of the body changes, a dark area is observed behind the calculus, there is a crystalline precipitate, the walls are thickened, the contours are deformed.
Polyps. Rounded formations are visible on the wall of the organ.
Oncology. If there are malignant formations on the monitor, elements larger than one centimeter will be visible, the contours of the organ are irregular in shape, the wall thickness is too large.

All functional deviations detected during an ultrasound examination necessarily require clarification and monitoring in dynamics.

In this regard, two weeks after the first procedure, a second examination is scheduled.

Ultrasound examination (also called echography) of the gallbladder is one of the highly informative, non-invasive and painless diagnostic techniques that allow assessing the condition of both this organ itself and the ducts leading to it.

Given the close connection of the gallbladder with the organs of the biliary system, the procedure can be complex, involving the simultaneous scanning of this organ, the pancreas and.

Indications

Echography of the gallbladder can be prescribed by a specialist gastroenterologist for:

the presence of constant pain in the right hypochondrium, which even painkillers cannot cope with (as a rule, such pains are manifestations of acute or chronic cholecystitis);
frequent feeling of bitterness in the mouth;
discomfort and feeling of heaviness in the liver;
severe yellowness of the mucous membranes and skin, observed in combination with nausea and vomiting, containing an admixture of bile;
abdominal trauma;
monitoring the condition of a patient who underwent surgery to remove the gallbladder and its ducts;
the presence of significant deviations from the norm of some (bilirubin, AST and ALT) indicators of a laboratory blood test;
cholelithiasis;
prescribing hormonal contraceptives (since in women prone to gallbladder diseases, taking hormonal birth control pills can not only accelerate the occurrence of gallstones, but also cause inflammation);
taking certain medications for too long;
the presence of obesity;
all kinds of intoxications of the body, in the first place - with the abuse of strong alcoholic beverages;
monitoring the functioning of the biliary system (if you suspect the presence of tumors or onset);
control over the effectiveness of the prescribed treatment;
suspected congenital pathology of the gallbladder.

Bile duct sonography is often included in a comprehensive examination of newborns and premature infants.

Reason for appointment ultrasound gallbladder in young children is:

yellowing of the whites of the eyes and skin;
frequent occurrence of diarrhea and vomiting;
the presence of abdominal pain of blurred localization;
lack of appetite;
unexplained weight loss.

often including too fatty, spicy, smoked and fried foods in their daily diet;
overly addicted to low-calorie diets;
eat very irregularly.

Contraindications

The undoubted advantage of echography is the complete absence of contraindications to its implementation. The only exceptions are cases of severe damage or violations of the integrity of the skin in the study area (for example, infectious lesions, open wounds or burns).

Preparation for ultrasound of the gallbladder with the definition of function

The set of measures to prepare the patient for an ultrasound examination of the gallbladder is completely identical to the program for preparing for ultrasound of all other internal organs located in the abdominal cavity.

For three to five days prior to the procedure, the patient must follow a diet that completely excludes the use of:

Too fatty foods.
Any alcoholic drinks.
Products that provoke the process of increased gas formation in the intestines.

products from yeast and rich dough;
whole wheat bread;
snacks;
fresh berries and fruits;
dishes from raw vegetables;
legumes;
cabbage in any (stewed, pickled, pickled) form;
any dairy products;
strong brewed tea;
any carbonated drinks;
coffee.

The patient is allowed to use:

cereals boiled in water;
white chicken meat;
lean beef;
fish (boiled or steamed);
low-fat cottage cheese;
soft-boiled eggs.

During meals or before meals, the patient is recommended to take enzymatic preparations containing pancreatin three times a day (such as: Festal, Creon, Mezim) and medicines that prevent the occurrence of flatulence (activated carbon or preparations "Motilium", "Espumizan", "Smekta"). You must start taking these medications at least 72 hours before your appointment.

On the eve of the scheduled examination:

The last meal should take place no later than 19 hours. Food should be light enough, but satisfying. An ideal option for such a dinner can be porridge cooked on water (without added sugar).
It is desirable that the bowels be emptied naturally. In extreme cases, it can be emptied with a microclyster, a glycerin suppository, or a mild laxative (most often, patients prone to constipation are prescribed lactulose).
Newborn babies and toddlers under one year of age should not be fed or watered three to three and a half hours before the start of the examination.
The period of abstinence from food and drink for babies under three years of age is four hours, and for children who have reached the age of eight - six hours.
Preparation for echography and the procedure for carrying out the procedure itself for children of the older age category is carried out in exactly the same way as activities intended for adult patients.

On the morning of the day for which the ultrasound is scheduled:

It is necessary to refuse breakfast if the procedure is carried out in the morning.
A light snack (for example, a cracker and a cup of weak tea) is allowed if the examination is scheduled for the afternoon. The duration of the interval separating breakfast from the diagnostic procedure should be at least six hours.
Smoking and chewing gum are prohibited.
It is necessary to completely refrain from drinking any liquid two to three hours before the study. Patients using life-saving medications that require drinking water should definitely consult with their healthcare professional.

Ultrasound examination of the gallbladder is always performed exclusively on an empty stomach.

Only under this condition, the organ, filled with bile to the maximum, will increase in size. With the use of even a small amount of liquid (and even more so food), the process of bile secretion starts, leading to compression of the gallbladder and significantly complicating the performance of a diagnostic examination.

Methodology

Ultrasound examination of the gallbladder can be:

Simple. For this type of procedure, an ultrasonic external sensor is used that receives information transabdominally (through the front wall of the abdomen). During the study, the patient assumes a supine position, freeing the upper abdomen from clothing covering it. Before starting the procedure, the doctor lubricates the scanning head of the transducer with a water-soluble gel that improves the permeability of ultrasonic waves by eliminating the interference, which is the air gap between the skin and the surface of the transducer. Patients in whom the bottom of the gallbladder is covered with bowel loops are asked to take a deep breath and hold their breath for a while. Some patients are asked to lie on their left side. If it is necessary to establish whether pathological inclusions are contained in the gallbladder (in the form of sand or stones), the doctor asks the patient to stand up and make several forward tilts of the body.
With a function definition. This variant of echography has several synonymous names. It is also called dynamic echocholescintigraphy or ultrasound diagnosis with a choleretic breakfast. With the help of this study, the doctor can evaluate the contractile function of the gallbladder in real time. The procedure consists of two stages. First, an initial examination of the examined organ on an empty stomach is performed, after which the patient must have breakfast with the products brought with him (he is warned about this by the doctor on the eve of the examination).

Cholagogue breakfast may consist of:

250 ml of heavy cream or sour cream (at least 25% fat);
the same amount of cottage cheese;
a few pieces of dark chocolate and a banana;
two chicken egg yolks (raw or boiled);
a slice of bread with butter (this breakfast option is considered not very successful, since the gallbladder does not contract actively enough after it, which also affects the results of the study);
sorbitol solution.

Ten minutes after the completion of breakfast, echography is performed three times (the intervals between sessions are five, ten and fifteen minutes). Reading is carried out in two positions of the patient:

lying on the back;
lying on the left side.

Having received the results of the study (the doctor of functional diagnostics deciphers them immediately), the patient can leave the office.

The duration of the standard procedure is about twenty minutes. Diagnosis with load - depending on the volume of echography - takes about an hour. Repeated diagnostics can be completed in fourteen days. Preventive research is carried out once a year.

Deciphering the study with and without exercise

During the procedure, the specialist evaluates:

localization (relative to nearby tissues and organs) and mobility of the gallbladder;
bile duct diameter;
dimensions, shape and thickness of the walls of the organ under study;
the severity of its contractile function;
the presence of pathological inclusions (neoplasms, sand, polyps and stones).

A normal gallbladder (the range of indicators is due to the dependence on the age of the patient and his general state of health) has:

length from 7 to 10 cm;
width from 3 to 5 cm;
size in diameter from 3 to 3.5 cm;
volume from 35 to 70 cm 3 ;
wall thickness - about 4 mm;
the diameter of the common bile duct is from 6 to 8 mm;
lobar bile ducts with an internal diameter not exceeding 3 mm.

A healthy organ has an oval or pear-shaped shape and clear contours. It is quite acceptable if its bottom protrudes 1.5 cm from under the lower edge of the liver.

The normal size of the gallbladder in infants and children under eight years of age is established, focusing on their height and body weight.

The technique of ultrasound examination of the gallbladder with a load makes it possible to assess not only the presence of structural abnormalities and changes, but also the performance of this organ.

An indicator of the norm is its reduction to 70% of the volume measured on an empty stomach, fifteen minutes after taking a choleretic breakfast. The results of measurements corresponding to this indicator indicate the normal motility of the gallbladder.

What does the survey show?

Ultrasound of the gallbladder can detect the presence of:

Acute cholecystitis, as evidenced by:
- thickening of the walls of the organ under study more than 4 mm;
- the presence of multiple internal partitions;
- an increase in the external parameters of the gallbladder;
- increased blood flow in the cystic artery;
- pain experienced by the patient when the sensor is pressed on the area of localization of the organ under study.
gangrenous cholecystitis, declaring itself an uneven increase in the thickness of the bladder wall. The echogram shows exfoliated particles of mucous membranes, clearly visible in the lumen of the organ.
Chronic cholecystitis, the clinical course of which is characterized by alternating periods of exacerbations and remissions, according to:
- a significant decrease in the size of the gallbladder;
- the presence of small inclusions visible in the lumen of the bubble;
- the presence of fuzzy blurry contours;
- compaction, thickening and deformation of the walls.
Cholelithiasis (cholelithiasis), the signs of which are the presence of:
- stones (small light formations) in the cavity of the organ, shifting both with a deep breath and with each change in body position;
- a dark area (echo shadow) behind the stones, resulting from the impermeability of these formations for ultrasonic waves;
- uneven contours and thickened walls;
- biliary sludge (sediment formed by bilirubin crystals), which should be differentiated from accumulations of pus or hemorrhages, which have similar features.

It is noteworthy that ultrasound is not able to detect the presence of small stones. Indirect evidence of their presence is the expansion of the diameter of the bile duct just above the clogged area.

Choledocholithiasis- a variety of cholelithiasis, characterized by the localization of stones not inside the bladder, but in the common bile duct (choledochus). Sonography reveals an expansion of the diameter of not only the choledochus, but also the intrahepatic bile ducts, as well as the presence of stones in their visible sections. Due to the peculiarities of localization (part of the sections of the common bile duct is located behind the intestines), the diagnosis of this disease using ultrasound is not always successful. In such cases, they resort to performing a procedure with a change in the postures of the patient being examined.
Dyskinesia of the gallbladder, manifested:
- inflection of this organ;
- an increase in the tone of the bladder walls and their compaction.
Tumors, the signs of which on the echogram are the presence of:
- formations with dimensions exceeding 10-15 mm;
- significant thickening of the walls;
- significant deformation of the external contours of the organ under study.
Hydrocele of the gallbladder, manifested by a significant increase in its size, provoked by blockage of the cystic duct, the culprit of which can be a stone.
Adenomyomatosis of the gallbladder- benign growth of the wall, in which all its layers are involved in the process. Ultrasound will show the presence of a thickening of the bladder wall, reaching 10 mm and making the internal lumen of the organ insignificant. Pathology can be distributed either in a separate section of the wall, or diffusely - throughout the bladder.
, looking on the echogram as rounded neoplasms localized on the walls of the gallbladder. Polyps larger than 10 mm in diameter are very often malignant. If repeated procedures indicate a rapid growth of the polyp, the doctor will conclude that the malignancy (malignancy) of the process has begun.
Congenital pathologies such as:
- the presence of diverticula - protrusions of the bladder walls;
- agenesis - the complete absence of the gallbladder;
- ectopic - atypical - localization (for example, between the right lobe of the liver and the diaphragm or behind the peritoneum) of the gallbladder;
- having a double gallbladder.

Price

The cost of an ultrasound of the gallbladder, as a rule, depends on the class of the medical institution and on the region in which it is located.

In specialized gastroenterological centers in Moscow:

the cost of a simple ultrasound examination of the gallbladder ranges from 500-1200 rubles;
for the procedure of ultrasound examination of the gallbladder with a load, the patient will have to pay from 700 to 1800 rubles.

A specialist examines the gallbladder by doing an ultrasound. This study is called non-invasive. Thanks to him, they diagnose:

cholecystitis;
in the biliary tract dyskinesia;
cholelithiasis, etc.

The gallbladder is quite difficult to properly examine. The specialist should examine its ducts on ultrasound, find out how often the organ contracts, how much it produces.

#1086;get ready.

The benefit of ultrasound is that very quickly the specialist will identify violations in the work of the organ. If the study is repeated, then he will understand what pathological changes have occurred since the last examination.

1069; this will help prescribe an adequate course of treatment.

The procedure is done in the clinic. It is carried out by a specially trained diagnostician (doctor). It happens that the gallbladder of a severe patient is examined at home.

Ways

Ultrasound of the gallbladder, like the liver, is done in 2 ways:

If the doctor wants to see a picture of how the pathologies inside the patient's gallbladder develop even more voluminously, he will prescribe an informative laparoscopy with thermography.

Getting ready for research

7 days before the scheduled procedure, preparation is required:

do not drink any alcohol;
try not to eat fatty;
do not eat those foods that cause gases in the intestines: pastries containing yeast (rye bread, etc.).
1076;.); raw fruits and vegetables; any legumes (beans, lentils, peas, etc.), fresh or raw milk; drinks with gas; cabbage; snacks: crackers containing aromatic and flavoring additives, chips, etc.

3 days before the study, you need to prepare:

at any main meal, no more than 3 times a day, drink medicines containing enzymes. These include: Mezim Forte or Creon, Mezim 10000, Plestal or Panzinorm 10000 with the famous Festal, etc. Check the dose with your doctor or follow the instructions.

1053; norm for an adult 10,000 units per appointment. This is 1 tablet "Mezim 10000" or 2 "Mezim Forte".

“In parallel, drink carminatives. Thanks to them, a minimum amount is formed in the intestines and gases will not linger. This may be preparation, reception: "Espumizan" or "Metsil", the famous "Motilium" or "Domperon". Adults most often take 1-2 tablets after a large meal.

If tomorrow is a study, have dinner no later than 19:00. Eat light and satiating food. Go to the toilet. Let the bowels empty naturally. Some tend to prepare by using glycerin suppositories or using drugs: Lactulac or Duphalac, etc. If you have constipation, take lactulose in advance.

BEFORE an ultrasound to examine the gallbladder, there is no need for an enema. In the morning, when the examination is in the afternoon, do not eat breakfast, do not drink anything. If for 2 half a day, then at 7 in the morning you can eat a light breakfast that will fill you up.

“If you are undergoing a procedure in the state. clinic, then bring a small towel with you. A gel will be applied to your stomach, and you will need to wipe it off after the examination is over. The private clinic provides disposable wipes, which are included in the price.”

If you are taking a child for an ultrasound scan, he most often does not need to take special medications, it is enough to follow a diet. Children under 1 year old are fed at least 3 hours before the ultrasound. If the baby is over 3 years old, then for 4 hours. Those who are under 8 can be given food for 6 hours. Seniors 8 years old should eat and prepare like adults, and a child needs a dose of medicine.

How is the procedure done?

This examination of the gallbladder is supposed to be done through the wall of the peritoneum. The patient lies on the couch and the doctor squeezes the gel onto the sensor itself and begins to drive along the stomach located on the table.

Diagnosis is painless, but if you have inflammation in the acute stage, then their presence already tells the doctor about the disease. The procedure is carried out for 20-40 minutes.

decryption

The doctor will tell you the results as soon as you get tested. The doctor will announce the size of your organ, the fullness of its walls. He will tell you what size ducts are and what kind of permeability they have. Can you clearly see if there are stones or sand? Assess the condition of the organs that are nearby and the tissues surrounding them.

Such an ultrasound examination of the gallbladder is completely harmless and very useful procedure. This study is available to every resident of Russia. If the doctor prescribes for you, be sure to go through and prepare, following the recommendations.

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Prolonged preparation for the procedure

To study the bile, you need to start preparing about seven days before the procedure. Preparation for the procedure of ultrasound of the gallbladder includes the following steps:

exclusion of any alcohol a week before the procedure;
restriction in fatty foods;
ban on fried foods;
the use of enzymatic agents with each meal three days before the ultrasound examination (Mezim, Festal, Panzinorm, Creon);
if necessary - the use of carminatives (Simethicone, Domperidone);
the use of activated charcoal, if a feeling of heaviness and discomfort persists in the stomach.

Three Day Diet

To reduce gas formation and eliminate flatulence, you can follow a three-day diet, with which you can prepare for the study as quickly and efficiently as possible. It is not difficult to follow such a diet, it contains enough proteins, fats and carbohydrates to feel full throughout the day. Eating is frequent, you need to eat every three to four hours in fractional portions. You can have a snack between main meals. So, the three-day diet includes:

General rules for preparing for ultrasound diagnostics

In order for the study to be successful, the day before the procedure, you must adhere to the following rules:

Do not eat foods that contribute to the accumulation and difficult discharge of gases from the intestines. These products include: legumes, dairy products, sweets, fresh pastries with yeast, raw vegetables and fruits, cabbage, snacks (chips, nuts, crackers, carbonated drinks). The gases formed after eating such food do not make it possible to objectively assess the size of the gallbladder, "supported" by the intestines.
It is best not to eat about a quarter of the day before the study. That is, if ultrasound is done in the morning, then in the evening you should not burden your stomach with food. Even a glass of water drunk before an ultrasound can change the picture. Normally, the gallbladder itself will accumulate a certain amount of bile, which will be evaluated by a specialist doctor.
Eat on the eve of the ultrasound as light as possible, but satisfying food.
Empty your bowels naturally.
If it is impossible to use natural defecation means such as Laktulak or Dufalac, it is possible to use glycerin suppositories, suppositories with bisacodyl.
Do not smoke, chew gum, or suck on hard candy immediately before the ultrasound.

If the patient is taking any drugs, he must notify the doctor who prescribes the ultrasound. Its function is to correct the therapy of other specialists, if there is no option to replace the drug. It is possible that when the patient is preparing for an ultrasound, the medication will have to be discontinued so that they do not affect the results of the study.

Ultrasound in young children

If an ultrasound examination is prescribed for children, then you need to prepare especially here, which is associated with the specifics of the nutrition of babies. Preparing for children is somewhat more difficult, because they are used to frequent meals and cannot refrain from feeding for a long time.

Children under one year old need to skip at least one feeding, that is, before the ultrasound, you do not need to eat from two to four hours. An hour before the procedure, the child should not drink. During this time, the gallbladder will already show its functions and diagnostics can be carried out. Toddlers from one to three years of age should fast for at least four hours and not drink for at least an hour, otherwise the results will be false. Children older than three years of age usually already have new eating habits, so they can fast for a long time. For this category, a fast of six to eight hours is recommended. Drinking liquids is prohibited one hour before the study.

Ultrasound examination in children is carried out with strict observance of the above rules. If the parents “regretted” and fed the baby, the food in the stomach will close the gallbladder, and the organ itself will have different parameters. False results obtained from such a procedure will cause it to be repeated, so parental responsibility is milestone preparing the baby for the diagnosis of the gallbladder.

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Preparing for an ultrasound of the gallbladder for adults

So what's to be done before ultrasound of the gallbladder? Preparation for this procedure is not particularly difficult, but, nevertheless, it is mandatory. So, two days before the procedure itself, doctors recommend dieting. It involves the exclusion or strict restriction of the use of foods that can provoke the process of gas formation: milk, black bread, crackers, peas, beans, cabbage, as well as apples, beer, other drinks, carbonated water. Adults should eat food for 6-7 hours before the examination, and stop drinking any liquid two hours before the examination. The study is carried out on an empty stomach, it is best to do it in the morning.

Preparing for an ultrasound of the gallbladder for children

It is worth noting that sometimes the procedure for ultrasound of the gallbladder is also done for children, and in order for the results of the study to be as accurate as possible, due attention should be paid to preparation.

If a child under the age of 1 year is being examined, you should try to skip at least one feeding, you cannot feed the baby immediately before the ultrasound at least 2-4 hours before the procedure. Fluid intake should also be limited.

Children from 12 months to 3 years - do not feed for 4-5 hours, do not give the child to drink liquids at least one hour before the procedure.

Children older than three years of age - the last meal before the procedure should be at least six hours before the study. If possible, it is better to conduct the examination early in the morning, then the child will be more comfortable.

If the child has problems with gas formation, a strict diet should be followed for a couple of days before the examination, then during the procedure the ultrasound results will be as accurate as possible.

What diseases are detected by ultrasound?

What diseases can be detected by ultrasound?

Cholelithiasis. Her symptoms are as follows: bouts of severe pain in the right hypochondrium, possibly nausea, vomiting;

Cholecystitis - the symptoms of the disease are as follows: fever, severe weakness, nausea, vomiting, severe pain in the right hypochondrium may occur;

Dropsy of the gallbladder;

Dyskinesia of the biliary tract. The disease may be accompanied by nausea, lack of appetite;

Dyskinesia of the gallbladder. The patient may experience a feeling of bitterness in the mouth, discomfort in the abdomen.

Features of ultrasound screening of the gallbladder

This examination has no contraindications. But, as mentioned, before ultrasound of the gallbladder certain foods should not be consumed. The examination does not cause discomfort and pain to a person and does not harm health. If necessary, such a procedure can be carried out many times, for example, in order to confirm the diagnosis, to find out how effective the treatment is. Ultrasound of the abdominal cavity requires a minimum of time, while the results will be quite informative and accurate.

moscow-doctor.rf

Indications

Echography of the gallbladder can be prescribed by a specialist gastroenterologist for:

the presence of constant pain in the right hypochondrium, which even painkillers cannot cope with (as a rule, such pains are manifestations of acute or chronic cholecystitis);
frequent feeling of bitterness in the mouth;
discomfort and feeling of heaviness in the liver;
severe yellowness of the mucous membranes and skin, observed in combination with nausea and vomiting, containing an admixture of bile;
abdominal trauma;
monitoring the condition of a patient who underwent surgery to remove the gallbladder and its ducts;
the presence of significant deviations from the norm of some (bilirubin, AST and ALT) indicators of a laboratory blood test;
biliary dyskinesia;
cholelithiasis;
prescribing hormonal contraceptives (since in women prone to gallbladder diseases, taking hormonal birth control pills can not only accelerate the occurrence of gallstones, but also cause inflammation);
taking certain medications for too long;
the presence of obesity;
all kinds of intoxications of the body, in the first place - with the abuse of strong alcoholic beverages;
monitoring the functioning of the biliary system (if you suspect the presence of tumors or the onset of a malignant process);
control over the effectiveness of the prescribed treatment;
suspected congenital pathology of the gallbladder.

The basis for the appointment of an ultrasound examination of the gallbladder in young children is:

yellowing of the whites of the eyes and skin;
frequent occurrence of diarrhea and vomiting;
the presence of abdominal pain of blurred localization;
lack of appetite;
unexplained weight loss.

often including too fatty, spicy, smoked and fried foods in their daily diet;
overly addicted to low-calorie diets;
eat very irregularly.

Contraindications

Preparation for ultrasound of the gallbladder with the definition of function

For three to five days prior to the procedure, the patient must follow a diet that completely excludes the use of:

Too fatty foods.
Any alcoholic drinks.
Products that provoke the process of increased gas formation in the intestines.

products from yeast and rich dough;
whole wheat bread;
snacks;
fresh berries and fruits;
dishes from raw vegetables;
legumes;
cabbage in any (stewed, pickled, pickled) form;
any dairy products;
strong brewed tea;
any carbonated drinks;
coffee.

The patient is allowed to use:

cereals boiled in water;
white chicken meat;
lean beef;
fish (boiled or steamed);
low-fat cottage cheese;
soft-boiled eggs.

On the eve of the scheduled examination:

The last meal should take place no later than 19 hours. Food should be light enough, but satisfying. An ideal option for such a dinner can be porridge cooked on water (without added sugar).
It is desirable that the intestines be emptied naturally. In extreme cases, it can be emptied with a microclyster, a glycerin suppository, or a mild laxative (most often, patients prone to constipation are prescribed lactulose).
Newborn babies and toddlers under one year of age should not be fed or watered three to three and a half hours before the start of the examination.
The period of abstinence from food and drink for babies under three years of age is four hours, and for children who have reached the age of eight - six hours.
Preparation for echography and the procedure for carrying out the procedure itself for children of the older age category is carried out in exactly the same way as activities intended for adult patients.

On the morning of the day for which the ultrasound is scheduled:

It is necessary to refuse breakfast if the procedure is carried out in the morning.
A light snack (for example, a cracker and a cup of weak tea) is allowed if the examination is scheduled for the afternoon. The duration of the interval separating breakfast from the diagnostic procedure should be at least six hours.
Smoking and chewing gum are prohibited.
It is necessary to completely refrain from drinking any liquid two to three hours before the study. Patients using life-saving medications that require drinking water should definitely consult with their healthcare professional.

Ultrasound examination of the gallbladder is always performed exclusively on an empty stomach.

Methodology

Ultrasound examination of the gallbladder can be:

Simple. For this type of procedure, an ultrasonic external sensor is used that receives information transabdominally (through the front wall of the abdomen). During the study, the patient assumes a supine position, freeing the upper abdomen from clothing covering it. Before starting the procedure, the doctor lubricates the scanning head of the transducer with a water-soluble gel that improves the permeability of ultrasonic waves by eliminating the interference, which is the air gap between the skin and the surface of the transducer. Patients in whom the bottom of the gallbladder is covered with bowel loops are asked to take a deep breath and hold their breath for a while. Some patients are asked to lie on their left side. If it is necessary to establish whether pathological inclusions are contained in the gallbladder (in the form of sand or stones), the doctor asks the patient to stand up and make several forward tilts of the body.
With a function definition. This variant of echography has several synonymous names. It is also called dynamic echocholescintigraphy or ultrasound diagnosis with a choleretic breakfast. With the help of this study, the doctor can evaluate the contractile function of the gallbladder in real time. The procedure consists of two stages. First, an initial examination of the examined organ on an empty stomach is performed, after which the patient must have breakfast with the products brought with him (he is warned about this by the doctor on the eve of the examination).

Cholagogue breakfast may consist of:

250 ml of heavy cream or sour cream (at least 25% fat);
the same amount of cottage cheese;
a few pieces of dark chocolate and a banana;
two chicken egg yolks (raw or boiled);
a slice of bread with butter (this breakfast option is considered not very successful, since the gallbladder does not contract actively enough after it, which also affects the results of the study);
sorbitol solution.

lying on the back;
lying on the left side.

Having received the results of the study (the doctor of functional diagnostics deciphers them immediately), the patient can leave the office.

Deciphering the study with and without exercise

During the procedure, the specialist evaluates:

localization (relative to nearby tissues and organs) and mobility of the gallbladder;
bile duct diameter;
dimensions, shape and thickness of the walls of the organ under study;
the severity of its contractile function;
the presence of pathological inclusions (neoplasms, sand, polyps and stones).

A normal gallbladder (the range of indicators is due to the dependence on the age of the patient and his general state of health) has:

length from 7 to 10 cm;
width from 3 to 5 cm;
size in diameter from 3 to 3.5 cm;
volume from 35 to 70 cm 3 ;
wall thickness - about 4 mm;
the diameter of the common bile duct is from 6 to 8 mm;
lobar bile ducts with an internal diameter not exceeding 3 mm.

A healthy organ has an oval or pear-shaped shape and clear contours. It is quite acceptable if its bottom protrudes 1.5 cm from under the lower edge of the liver.

The normal size of the gallbladder in infants and children under eight years of age is established, focusing on their height and body weight.

What does the survey show?

Ultrasound of the gallbladder can detect the presence of:

Acute cholecystitis, as evidenced by:
- thickening of the walls of the organ under study more than 4 mm;
- the presence of multiple internal partitions;
- an increase in the external parameters of the gallbladder;
- increased blood flow in the cystic artery;
- pain experienced by the patient when the sensor is pressed on the area of localization of the organ under study.
gangrenous cholecystitis, declaring itself an uneven increase in the thickness of the bladder wall. The echogram shows exfoliated particles of mucous membranes, clearly visible in the lumen of the organ.
Chronic cholecystitis, the clinical course of which is characterized by alternating periods of exacerbations and remissions, according to:
- a significant decrease in the size of the gallbladder;
- the presence of small inclusions visible in the lumen of the bubble;
- the presence of fuzzy blurry contours;
- compaction, thickening and deformation of the walls.
Cholelithiasis (cholelithiasis), the signs of which are the presence of:
- stones (small light formations) in the cavity of the organ, shifting both with a deep breath and with each change in body position;
- a dark area (echo shadow) behind the stones, resulting from the impermeability of these formations for ultrasonic waves;
- uneven contours and thickened walls;
- biliary sludge (sediment formed by bilirubin crystals), which should be differentiated from accumulations of pus or hemorrhages, which have similar features.

Choledocholithiasis- a variety of cholelithiasis, characterized by the localization of stones not inside the bladder, but in the common bile duct (choledochus). Sonography reveals an expansion of the diameter of not only the choledochus, but also the intrahepatic bile ducts, as well as the presence of stones in their visible sections. Due to the peculiarities of localization (part of the sections of the common bile duct is located behind the intestines), the diagnosis of this disease using ultrasound is not always successful. In such cases, they resort to performing a procedure with a change in the postures of the patient being examined.
Dyskinesia of the gallbladder, manifested:
- inflection of this organ;
- an increase in the tone of the bladder walls and their compaction.
Tumors, the signs of which on the echogram are the presence of:
- formations with dimensions exceeding 10-15 mm;
- significant thickening of the walls;
- significant deformation of the external contours of the organ under study.
Hydrocele of the gallbladder, manifested by a significant increase in its size, provoked by blockage of the cystic duct, the culprit of which can be a stone.
Adenomyomatosis of the gallbladder- benign growth of the wall, in which all its layers are involved in the process. Ultrasound will show the presence of a thickening of the bladder wall, reaching 10 mm and making the internal lumen of the organ insignificant. Pathology can be distributed either in a separate section of the wall, or diffusely - throughout the bladder.
Polyps that look on the echogram as rounded neoplasms localized on the walls of the gallbladder. Polyps larger than 10 mm in diameter are very often malignant. If repeated procedures indicate a rapid growth of the polyp, the doctor will conclude that the malignancy (malignancy) of the process has begun.
Congenital pathologies such as:
- the presence of diverticula - protrusions of the bladder walls;
- agenesis - the complete absence of the gallbladder;
- ectopic - atypical - localization (for example, between the right lobe of the liver and the diaphragm or behind the peritoneum) of the gallbladder;
- having a double gallbladder.

Price

The cost of an ultrasound of the gallbladder, as a rule, depends on the class of the medical institution and on the region in which it is located.

In specialized gastroenterological centers in Moscow:

the cost of a simple ultrasound examination of the gallbladder ranges from 500-1200 rubles;
for the procedure of ultrasound examination of the gallbladder with a load, the patient will have to pay from 700 to 1800 rubles.

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General description of the study

Ultrasound diagnostics (or echography) is today recognized as the most effective and simple method of medical diagnostics. The use of ultrasonic waves in the study of internal organs has no contraindications and consequences in comparison with X-rays, it costs less than computed tomography, and is also a quick and absolutely painless procedure.

Most often, ultrasound is used in the diagnosis of the abdominal organs (liver, pancreas and gallbladder) and pelvis, heart and breast, brain and joints.

Ultrasound of the gallbladder in modern medicine has a number of advantages over classical diagnostic methods, in particular, cholecystography (X-ray examination). Due to absolute safety and the absence of contraindications, echography is actively used in the diagnosis of diseases of the gallbladder and liver in newborns, pregnant women, and elderly patients.

Ultrasound is of particular importance in the diagnosis of gallstone disease. Unlike x-rays, echography allows not only to determine deviations from the norm of the main parameters of the organ under study, but also to determine the clear localization and size of stones up to 2 mm and even the presence of sand.

Indications for carrying out

Ultrasound of the gallbladder is prescribed to patients with suspected congenital anomalies, characteristic symptoms of gallbladder disease, and also as an additional examination with an unclear diagnosis. The norm of ultrasound and its interpretation help to recognize developmental anomalies, cholecystitis, the presence of stones, dropsy and empyema (accumulation of pus in the gallbladder).

Indications for ultrasound of the gallbladder and liver in some cases may coincide. A doctor usually orders an ultrasound scan of the gallbladder for the following symptoms:

all typical signs of acute and chronic cholecystitis;
pain in the right hypochondrium of varying strength and character;
icteric color of the skin;
nausea and vomiting (especially with an admixture of bile);
abdominal trauma;
recovery after surgery on the gallbladder and its ducts (to monitor the patient's condition).

Ultrasound of the gallbladder is also recommended for a comprehensive examination of newborns, including premature ones. In older children, echography may be required for yellowing of the skin and whites of the eyes, diarrhea and vomiting, causeless weight loss and poor appetite, abdominal pain of unclear localization, etc.

Preparation for the event

Preparation for an ultrasound of the gallbladder requires only two prerequisites: the intestines must be empty and without accumulation of gases, and food and drinks must be stopped 7-8 hours before the ultrasound, so that bile has time to accumulate in the bladder.

In order to successfully prepare for an ultrasound of the liver and gallbladder and prevent distortion of the analysis results, it is important to follow a few recommendations.

3-5 days before the ultrasound, stop drinking alcohol and exclude from the diet all foods that can provoke gas formation: yeast baked goods, cabbage in any form, all legumes, fresh fruits and milk.
3 days before the ultrasound, start taking food enzymes with meals (2-3 times a day).
Empty your bowels the night before the test. If you are prone to constipation, you can drink lactulose, use a glycerin suppository, or take an enema.
Try to schedule an echography for the first half of the day: in this case, you can prepare more thoroughly, and the interpretation of the analyzes will be as accurate as possible. In the evening before the ultrasound, a light dinner is allowed no later than 7 pm, after that - no food and liquid.
If you need to do an ultrasound of the gallbladder or liver for infants, it is enough for the child not to feed or drink for 3-3.5 hours.

Preparation for a functional ultrasound

In some cases, the doctor may prescribe a study of the function of the gallbladder (functional ultrasound), as a result of which not only the norm of the gallbladder is checked (volume, wall thickness, dimensions, etc.), but also its contractility.

With such an ultrasound, you first need to make a diagnosis on an empty stomach. Then the patient has breakfast, and after 10 minutes a secondary echography is performed to assess the function of the bladder and its ducts. Then 2 more studies are needed - with an interval of about 15 minutes.

In order for the functional ultrasound to be successful and the interpretation of the results to be as accurate as possible, a special choleretic breakfast is needed. To do this, the patient is recommended to take the following products with him to the hospital: 200-400 ml of cream (at least 20%) or sour cream, a few slices of dark chocolate.

Interpretation of analysis results

Deciphering the results of ultrasound of the gallbladder and liver is usually carried out in the near future after scanning. The doctor evaluates not only the main parameters of the organ, but also determines the size and patency of the bile ducts, the presence or absence of stones, and reveals the state of neighboring organs and tissues.

The norm of ultrasound for the gallbladder includes the following items:

shape (pear-shaped, cylindrical);
dimensions (length and width);
wall thickness (norm - 3-5 mm);
formations in the lumen (the norm is their absence);
acoustic shadow from formations (stones and tumors);
displacement of stones - they can move freely or be soldered to the wall of the bubble.

The size of the gallbladder in each patient can vary greatly. In an adult, the norm is: 6–10 cm long, 2–4 cm wide. In children, the norm depends on age: the length of the organ is from 5.5 to 6.5 cm, the width is 1.7–2.4 cm .

Deciphering the results of ultrasound allows you to diagnose the following diseases: acute and chronic cholecystitis, gallbladder dyskinesia (impaired outflow of bile), cholelithiasis, dropsy, polyps and tumors. If the decoding includes information about any deformations, this may signal structural features or developmental anomalies.

Ultrasound of the gallbladder is a very simple and popular diagnostic method, so it is possible to make such a scan in any major city. The study has no side effects, takes a minimum of time and does not bring any inconvenience to the patient. The cost of echography usually ranges from 1-2 thousand rubles, depending on the region and clinic.

Ultrasound examination of the gallbladder with the definition of function is an informative, and most importantly, absolutely safe and painless manipulation. Thanks to this diagnosis, many diseases can be detected at an early stage. To get reliable results, the procedure requires careful preparation.

Who is shown the procedure

Because ultrasound does not negative impact on the body, diagnostics are indicated not only for adults, but also for children. Most doctors say that it is mandatory to undergo an ultrasound scan for the following complaints:

Constant feeling of nausea
Belching with a bad taste in the mouth
Pain in the gallbladder of unknown etiology
Regular heaviness in the abdomen
Lack of appetite
Skin color changes

Being overweight
Injuries of internal organs
Long term drug treatment
severe poisoning
Suspicion of the presence of stones, malignant neoplasms and congenital anomalies of the gallbladder
Chronic pancreatitis, cholecystitis

In infants, such an examination may be prescribed due to unstable stools of unclear etiology or with profuse vomiting of a regular nature. Older children may complain of disturbing symptoms on their own. Usually they indicate a pressing and unpleasant pain at the location of the gallbladder.

If you suffer from the above ailments, go to a medical facility as soon as possible and undergo a diagnosis.

Possible contraindications

Unlike other studies, ultrasound has no direct contraindications to conduct. An exception is a violation of the integrity of the skin in the area under study (for example, burns).

What will the ultrasound show

Based on the results of the examination, diseases such as:

Cholecystitis of various forms
The presence of stones in the gallbladder
Congenital anomalies of the organ
The presence of neoplasms
agenesia
Dropsy
Changes in the structure and size of the organ

If the disease is detected in a timely manner, in this case, one can hope for a favorable outcome. Most pathologies at an early stage can be cured with the help of medications. If we are talking about a neglected form of the disease, surgical intervention may be required.

How to properly prepare

For the results to be informative, the patient must undergo special training. Three days before the scheduled date of the study, it is required to stop eating fried, spicy, too fatty and smoked foods. Also banned alcoholic drinks, bread, mushrooms, soda, various fast food, flour and confectionery. These days, a low-calorie diet is shown, consisting of cereals on the water, dietary meat, vegetables and fruits (exclusively after heat treatment), as well as fermented milk products.

If the patient is concerned about bloating or flatulence, you need to start taking carminative drugs in three days according to the instructions. Be sure to discuss your medications with the doctor who ordered you to study. Consider a few rules that must be observed on the eve of an ultrasound of the gallbladder with the definition of function:

The last meal should be taken at least 12 hours before. Dinner should be light, best of all - consisting of sour-milk products, for example, low-fat cottage cheese with sour cream and a glass of green tea. If we are talking about a small child, the last meal is recommended 3-4 hours before the ultrasound
Before the study, it is recommended to clean the intestines from feces. If this cannot be done naturally, make a cleansing enema at home.
When you wake up in the morning, skip breakfast
Smoking and chewing gum are strictly prohibited 3-4 hours before
If you are taking any medications, be sure to tell your doctor about it.

As for preparing for the study of the child, you should consult with your doctor. The fact is that depending on the age and other individual characteristics, the specialist can make some adjustments to the preparation process.

Stages

An ultrasound of the gallbladder with function determination usually takes 1 to 2 hours. For this reason, "at the request" of the patient, this type of examination is not carried out - only according to indications and referral from the attending physician. Diagnostic manipulation is carried out in several stages.

First, a person lies on the couch on his back, takes off his clothes to the waist. A standard examination is carried out using a special sensor. For better glide, the area under study is lubricated with a silicone-based gel. The specialist determines the size of the organ, structures, and so on. In a word, first of all, an ultrasound of the gallbladder is performed without examining its function. This diagnostic procedure is performed exclusively on an empty stomach.

The second stage is the study of the function of the organ. Many people wonder why they conduct an initial examination without breakfast? This is necessary so that the doctor can assess the state of the body before and after eating, since many patients complain of unpleasant symptoms just after eating. A patient in an ultrasound doctor's office eats breakfast, usually consisting of fermented milk products or boiled chicken eggs. Next, a re-examination is carried out.

The third stage has no features. The food is allowed to digest a little and after half an hour, an ultrasound examination is again carried out. The final check is one hour after breakfast. The specialist examines the body in various positions of the body: sitting, lying on the right and left side, standing.

Deciphering the results

Firstly, you should not worry too much if the doctor sent you for a gallbladder diagnosis. According to statistics, in most cases, all disturbing symptoms are associated only with malnutrition or alcohol abuse. Oncological diseases in this localization are found extremely rarely. When conducting an ultrasound examination with the definition of function, the doctor evaluates the following factors:

Organ length
Thickness
Width
The condition of the mucosa
Contours of the gallbladder
Volume
The form
Location
The presence of foreign bodies

After a person has taken food, the volume of the gallbladder should decrease slightly, by about 45-55% compared to the results in the first stage of the study.

The norm of the gallbladder

Normally, this body has the following indicators:

Length varies from 6 to 9 centimeters
Width - 2-4 cm
Capacity up to 70 cm3
The wall thickness is 3 mm

The gallbladder without anomalies and pathologies has clear contours. The shape of the organ is pear-shaped. Please note that these figures may vary slightly depending on individual characteristics. For example, a person's age and weight play a role. To verify your results, consult a specialist in this field.

Preventive actions

To avoid having to resort to various types examinations and in the future worry about the results, spend money on treatment, etc., it is enough to observe proper nutrition and lead a healthy lifestyle. Start by avoiding alcohol, nicotine, fatty, smoked foods. Watch the amount of salt (no more than 5 grams per day), drink enough water and move more.

If you have any worrying symptoms, contact your doctor immediately. Remember that early diagnosis greatly simplifies and shortens treatment time.

Alternative names: ultrasound of the gallbladder after a test breakfast, ultrasound of the hepatobiliary system (including the gallbladder), assessment of the motor-evacuation function of the gallbladder using ultrasound.

Ultrasound of the gallbladder with the study of function is a diagnostic manipulation that allows you to determine the functional state of the gallbladder using ultrasound. During the study, an ultrasound of the gallbladder on an empty stomach is performed and it is re-examined after a light breakfast. This allows you to evaluate the function of this organ in dynamics.

Eating a certain amount of food (trial breakfast) stimulates bile secretion. Tracking the change in the volume of the gallbladder after eating, you can assess its functional state.

Indications for ultrasound of the gallbladder

Ultrasound of the gallbladder with a study of its function is indicated in the following cases:

If you suspect biliary dyskinesia (especially in children).
With chronic and acute cholecystitis.
Suspicion of polyps of the gallbladder.
With endocrine diseases.

The basis for the appointment may be the following complaints from the patient:

Dull aching pain in right hypochondrium.
Chair disorders.
Dyspeptic disorders in the form of bloating, constipation, bitterness in the mouth.

These symptoms can be secondary and occur with endocrine diseases, autoimmune diseases, and nutritional errors. More often, a more detailed examination is required to establish an accurate diagnosis.

Contraindications

The procedure is contraindicated in the presence of gallstone disease, when there are a large number of small stones in the gallbladder lumen that can block the bile duct.

Training

The general principles of preparation for ultrasound of the abdominal organs are observed:

a few days before the study, you should abandon products that promote gas formation - from black bread, raw vegetables, dairy products;
for 2-3 days, it is recommended to take drugs that normalize digestion - enzymes (pancreatin or its analogues), carminative drugs and drugs that normalize stool;
the last meal is 8-9 hours before the ultrasound, a light dinner is recommended.

You must bring groceries with you to the specialist's office - 1-2 boiled eggs, a couple of bananas or chocolate. In some clinics, a solution of Sorbitol is used to stimulate bile secretion.

How is an ultrasound of the gallbladder with a study of function

First, an ultrasound of the gallbladder at rest is performed. Its dimensions, the thickness of the bubble wall are estimated. After that, the patient eats a light breakfast or drinks 50-100 ml of sorbitol. After 10 minutes, a second ultrasound of the gallbladder is performed with an assessment of its size. In some cases, 2 more studies are performed with an interval of 15 minutes, after which the procedure is considered completed.

Interpretation of results

During the study, the linear dimensions of the gallbladder are evaluated, and its volume is also calculated.

Normal indicators:

length - 4-13 cm;
width - 2-4 cm;
wall thickness - up to 4 mm;
volume - 21-25 ml.

After eating, there is a contraction of the gallbladder, during which bile is released into the intestinal lumen. The norm is a decrease in the volume of the bladder by 40-60% - up to 13-15 ml in 20-30 minutes. In this case, one speaks of a normal motor-evacuation function. After 45 minutes, the restoration of the volume of the bladder begins due to the bile synthesized by the liver.

The slowdown in the process of emptying is interpreted as dysfunction of the gallbladder according to the hypokinetic type, the acceleration of the process indicates dysfunction according to the hyperkinetic type.

Additional Information

This research method allows you to most effectively assess the condition of the gallbladder. In this case, the patient is delivered a minimum of discomfort, since the procedure is non-invasive. An alternative is multifractional duodenal sounding, however, this procedure is too unpleasant for patients and is used extremely rarely due to the large number of contraindications.

A more accurate method is cholescintigraphy with the introduction of cholecystokinin, but this is a more complex method, during which the patient is subjected to radiation exposure.

Literature:

Laboratory and instrumental research in diagnostics: a Handbook / Per. from English. V.Yu. Khalatov; Ed. V.N. Titov. - M.: GEOTAR-MED, 2004. - 960 p.
Guide to ultrasound diagnostics / Ed. Palmera. - M.: Medicine, 2000.