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Case of the Month

June 2018

Patient Data: Middle age female patient Examined for SONOZORG A primary care ultrasound facility

Clinical Info: Incidental finding


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If you look carefully you can see a small layer of thick bile


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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


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After turning the patient on his left side the lesion moves and changes form and finally disappears


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After turning the patient on his left side the lesion moves and changes form. So the lesion proved to be sludge


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This is a second patient with a large sludge ball


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This is another patient with a large sludge ball


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This lesion also looks like it could be a polyp, but watch out when you use color doppler


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Not every color doppler signal means flow like in this case

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

For more cases of thick bile mimicking polyps see

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