June 2018

Is it a polyp or something else?

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Clinical information

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

Transverse image

After turning the patient on his left side the lesion disappears

This is another patient with a large sludge ball

This is is a fourth patient with a large sludge ball

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

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

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Fujifilm Ultrasound System

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Author

Dr. Taco Geertsma

Retired Radiologist, Gelderse Vallei Hospital

Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.

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