Ultrasound of the biliary tract is a diagnostic method during which the skin is not affected by needles or various surgical instruments. It allows you to find out very accurate information about the state of the gallbladder and its ducts. As a rule, the study of this organ is carried out as part of a comprehensive study of the abdominal organs and especially often in conjunction with ultrasound of the liver.
Indications for diagnostics
The gastroenterologist may prescribe an ultrasound method for diagnosing the gallbladder in the following situations:
- repeated pain on the right side of the hypochondrium, which can only be removed with painkillers;
- discomfort and feeling of heaviness in the liver;
- taste of bitterness in the mouth;
- yellow color of the skin and external mucous membranes;
- irregularpower mode;
- abuse of fatty, smoked, spicy, fried foods;
- too much low-calorie diets;
- drugs taken too long;
- abnormal values in a laboratory blood test (AST, ALT, bilirubin and others);
- biliary dyskinesia;
- obesity;
- gallstone disease;
- abdominal injury;
- when prescribing and choosing female hormonal contraceptives;
- the process of monitoring the condition of the biliary tract in the presence of tumors;
- monitoring the effectiveness of therapy.
Contraindications for testing
This study is a completely safe procedure. Therefore, the only contraindication to the use of ultrasound of the biliary tract is severe damage to the skin in the area of examination. For example, burns, wounds, infections.
Preparation for ultrasound diagnosis of the gallbladder
Preparation for this process of diagnosing the biliary tract is mostly the same as the program for preparing for ultrasound of other abdominal organs. A few days before the diagnosis, you should stop drinking alcohol and fatty foods, and also products that stimulate the formation of gases in the intestines, which include:
- raw fruits, vegetables and berries;
- lactic acid products;
- cereal bread and other yeast dough products;
- legumes;
- strong tea, coffee and carbonated drinks.
Patients often ask what to eat before the procedure.
The following foods are allowed:
- porridge boiled in water;
- low-fat cottage cheese;
- beef or chicken meat;
- steam or boiled fish;
- soft-boiled eggs.
During meals, it is necessary to use various enzyme preparations ("Creon", "Festal", "Mezim") and drugs that reduce flatulence ("Smecta", "Espumizan", "Activated charcoal", "Motilium"), but no more than three times a day.
In the evening before the ultrasound of the biliary tract, it is recommended to follow the following rules:
- The last meal should be light and satisfying, for example, you can eat porridge cooked in water without sugar, but no later than 19 pm.
- You should empty your bowels naturally. If there are difficulties, then it is necessary to use mild laxatives or a microclyster.
This is not all preparation for the ultrasound of the biliary tract.
The morning before the procedure:
- if the study is planned to be carried out in the morning, then you should refuse breakfast;
- if the procedure was scheduled for the 2nd half of the day, then a light breakfast is allowed - crackers and tea (the interval between the study and breakfast should be at least 6 hours);
- you can not drink liquids a few hours before the diagnosis, so you should consult withspecialist about taking life-saving medicines;
- also do not chew gum or smoke.
It is worth remembering that endo-ultrasound of the biliary tract must be carried out strictly on an empty stomach, because in this case the gallbladder is filled with bile to the maximum, due to which it increases. If you drink even a little liquid, then the bile excretion processes will start, and the bladder will decrease in size, which will greatly complicate the examination.
Survey method
With biliary dyskinesia, ultrasound of all internal organs of the digestive tract will be the best option. For this reason, it is advisable to carry out the procedure in a specialized medical center and be observed by one attending physician.
Simple ultrasound of the gallbladder
Ultrasound of the liver and biliary tract is performed using external sensors on the anterior abdominal wall. The patient needs to lie on his back and get rid of clothing in the upper abdomen. After that, the doctor applies a special water-soluble gel to the transducer in order to eliminate the air gap upon contact with the skin and facilitate the passage of ultrasonic waves.
If the bottom of the biliary tract is covered with intestinal loops, the doctor will ask the patient to take a deep breath and hold his breath for as long as possible, or roll over to his left side.
To identify pathological inclusions in the biliary tract (sand, stones), the patient mayask to stand up and do a few forward bends.
Preparation for ultrasound of the liver and biliary tract must be carried out without fail.
Ultrasound diagnosis of the biliary tract with function detection
Another name for the diagnostic method is ultrasound with a choleretic breakfast or dynamic cholescintigraphy.
This procedure allows you to determine what the contractile function of the gallbladder is in real time.
After the first biliary tract diagnostic procedure on an empty stomach, the patient must take a trial breakfast of two boiled (or raw) yolks and 250 g of cottage cheese (or sour cream). Also in the form of a choleretic breakfast, you can use a solution of sorbitol.
After this, the ultrasound examination must be repeated at intervals of 5, 10 and 15 minutes.
Ultrasound diagnostics for removed gallbladder
Another name for the procedure is dynamic choledochography.
First, the doctor evaluates the diameter and condition of the bile duct (strictly on an empty stomach). After that, the patient is given a food load in the form of sorbitol dissolved in water, and then re-diagnosis is carried out again after 0.5-1 hours.
During the study, the doctor must record the patient's complaints about the appearance of pain, increase, intensity, its absence or duration.
Deciphering ultrasound of the biliary tract
During the examination, the doctor should evaluate the following data:
- location and mobility of the gallbladder;
- thickness, size and shape of the walls of the organ;
- presence of neoplasms, polyps and stones;
- contractile function of the gallbladder;
- diameter of bile ducts.
Normal gallbladder sizes are:
- width about 4cm;
- length ranging from 8 to 10cm;
- transverse size from 3 to 3.5 cm;
- volume 30-70 cu. see;
- diameter of the common bile duct about 7mm;
- no more than 4 mm wall thickness;
- The internal diameter of the ducts of this organ should be no more than 3 mm.
The gallbladder should be oval or pear-shaped, with clear contours. It is allowed to highlight the bottom of the bladder by 1-1.5 cm from under the edge of the liver.
What does an ultrasound of the biliary tract show?
Thanks to the ultrasound examination of this organ, many diseases can be determined.
Acute cholecystitis is indicated by the following data:
- many internal partitions;
- gall bladder wall thicker than 4mm;
- organ increased in size;
- there is increased blood flow in the cystic artery.
The chronic form of this disease can be identified by the following symptoms:
- outlines fuzzy and blurry;
- gall bladder has decreased in size;
- the walls of the organ became denser, deformed and thicker;
- small inclusions can be seen in the lumen of the bubble.
Biliary dyskinesia is determined bythe presence of one or more constrictions in the gallbladder, as well as finding a seal and an increase in the tone of the walls of the organ.
The following pathologies indicate the presence of gallstone disease:
- rough contours and thickening of the organ wall;
- the presence of stones in the cavity of the gallbladder, which move when changing the position of the body;
- the presence of a dark area behind the stone;
- presence of bilirubin crystals in urine sediment.
It is worth remembering that ultrasound does not show small stones. They can be identified by dilatation of the bile duct just above the blockage.
Presence of polyps of the biliary tract by the presence of round formations on the wall of the organ under study. If the polyp has a diameter of more than 11 cm, then there is a risk of developing a malignant tumor. If during the repeated ultrasound diagnosis an accelerated growth of the polyp is recorded, then this will indicate that the process is malignant.
Existing tumors are determined by the presence of formations at least 1-1.5 cm in size, deformed contours of the organ under study, as well as an excessively thickened wall of the gallbladder.
Any congenital pathologies can be identified by:
- ectopic localization of the gallbladder;
- lack of bile ducts;
- accessory gallbladder;
- protrusion of the wall.
All pathologies detected by ultrasound of the biliary tract require clarification and dynamicobservations. For this reason, after the first examination procedure, the doctor prescribes a second one - in two or three weeks.
It is necessary to repeat the study regularly, even if no abnormalities were found.
