Ultrasound of the biliary tract is called a diagnostic method, during which no exposure to needles or various surgical instruments is exerted on the skin. 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 an ultrasound of the liver.
Indications for diagnosis
An ultrasound diagnostic method for the gallbladder can be prescribed by a gastroenterologist in the following situations:
- repeated painful sensations on the right side of the hypochondrium, which can be removed only with the help of painkillers;
- discomfort and a feeling of heaviness in the liver;
- taste of bitterness in the mouth;
- yellow color of the skin and external mucous membranes;
- irregular diet;
- abuse of fatty, smoked, spicy, fried foods;
- too frequent use of low-calorie diets;
- taking medications too long;
- abnormal indicators in a laboratory blood test (AST, ALT, bilirubin and others);
- biliary dyskinesia ;
- obesity;
- cholelithiasis;
- abdominal injuries;
- in the appointment and selection of female hormonal contraceptives;
- the process of monitoring the state of the biliary tract in the presence of tumors;
- monitoring the effective effects of therapy.
Contraindications to the study
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 examination area. For example, burns, wounds, infectious lesions.
Preparation for ultrasound diagnosis of the gallbladder
The preparation for this process of diagnosing the biliary tract is for the most part the same as the preparation program for ultrasound of other organs of the abdominal cavity.
A few days before the diagnosis, you should abandon the use of alcohol and fatty foods, as well as products that stimulate the formation of gases in the intestines, which include:
- raw fruits, vegetables and berries;
- lactic acid products;
- cereal bread and other products from yeast dough;
- legumes;
- strong tea, coffee and carbonated drinks.
Patients often ask what to eat before the procedure.
The following foods are allowed to be eaten:
- cereals boiled in water;
- skim cheese;
- beef or chicken;
- steam or boiled fish;
- soft-boiled eggs.
While eating, you need to use various enzyme preparations (Creon, Festal, Mezim) and drugs that reduce flatulence (Smecta, Espumisan, Activated Carbon, Motilium), but not more than three once a day.
In the evening before the ultrasound of the biliary tract, it is recommended to observe 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 hours.
- Empty the intestines naturally. If you have any difficulties, it is necessary to use mild laxatives or microclysters.
This is not all preparation for ultrasound of the biliary tract.
In 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 - cracker and tea (the interval between the study and breakfast should be at least 6 hours);
- you can not drink liquid a few hours before the diagnosis, so you should consult with a specialist about taking vital medicines;
- also do not use chewing gum and smoke.
Do not forget that endo-ultrasound of the biliary tract must be performed strictly on an empty stomach, because in this case the gallbladder is filled with bile as much as possible, due to which it increases. If you even drink a little liquid, bile-excreting processes will start, and the bubble will decrease in size, which will greatly complicate the examination.
Survey method
With biliary dyskinesia, an ultrasound of all the 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 undergo monitoring by one attending physician.
Simple ultrasound diagnosis 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 clothes in the upper abdomen. After that, the doctor applies a special water-soluble gel to the sensor in order to eliminate air gap upon contact with the skin and facilitate the passage of ultrasonic waves.
If the bottom of the biliary tract is covered with loops of the intestine, 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 may be asked to stand up and make several bends forward.
Preparation for ultrasound of the liver and biliary tract should be carried out without fail.
Ultrasound diagnosis of biliary tract with detection of function
Another name for the diagnostic method is an ultrasound with a choleretic breakfast or cholecintigraphy. dynamic.
This procedure allows you to determine what is the contractile function of the gallbladder in real time.
After the first procedure for the diagnosis of biliary tract on an empty stomach, the patient must take a test breakfast of two boiled (or raw) yolks and 250 g of cottage cheese (or sour cream). Also in the form of choleretic breakfast, you can use a solution of sorbitol.
After this, the ultrasound should be repeated with an interval of 5, 10 and 15 minutes.
Ultrasound Diagnosis with Remote Gallbladder
Another name for the procedure is dynamic echo-choledochography.
First, the doctor assesses 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-diagnosed again after 0.5-1 hours.
During the study, the doctor should record the patient's complaints about the appearance of pain, growth, intensity, its absence or duration.
Decoding ultrasound of the biliary tract
During the study, the doctor should evaluate the following data:
- the location and mobility of the gallbladder;
- thickness, size and shape of the walls of the organ;
- the presence of neoplasms, polyps and stones;
- contractile function of the gallbladder;
- bile duct diameter.
The normal sizes of the gallbladder are:
- width about 4 cm;
- length ranging from 8 to 10 cm;
- transverse size from 3 to 3.5 cm;
- volume 30-70 cubic cm;
- diameter of the common bile duct about 7 mm;
- not 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 have an oval or pear-shaped, clear contours. Allowed the allocation of the bottom of the bladder 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 identified.
The following data indicate acute cholecystitis:
- many internal partitions;
- the gallbladder wall is thicker than 4 mm;
- the body has increased in size;
- there is increased blood flow in the cystic artery.
The chronic form of this disease can be determined by the following symptoms:
- the contours are fuzzy and blurry;
- the gall bladder has decreased in size;
- the walls of the organ became denser, deformed and became thicker;
- small inclusions can be seen in the lumen of the bubble.
Dyskinesia of the biliary tract is determined by the presence of one or more constrictions in the gallbladder, as well as finding a seal and increased tone of the walls of the organ.
The following pathologies indicate the presence of cholelithiasis :
- uneven contours and thickening of the organ wall;
- the presence in the cavity of the gallbladder of stones that move when the body position changes;
- the presence of a dark area behind the stone;
- the presence of bilirubin crystals in the urine sediment.
It is worth remembering that ultrasound does not show stones of small sizes. They can be detected by the expansion of the bile duct just above the blockage.
The presence of biliary tract polyps by the presence of rounded formations on the wall of the studied organ. If the polyp has a diameter of more than 11 cm, then there is a risk of developing a malignant formation. If during the repeated ultrasound diagnostics an accelerated growth of the polyp is recorded, this will indicate that the process is malignant.
Existing tumors are determined by the presence of formations with a size of at least 1-1.5 cm, deformed contours of the organ under investigation, and also an excessively thickened wall of the gallbladder.
Any congenital pathology can be identified by:
- ectopic localization of the gallbladder;
- lack of biliary tract;
- additional gall bladder;
- protrusion of the wall.
All pathologies detected by ultrasound of the biliary tract require clarification and dynamic observation. For this reason, after the first test procedure, the doctor prescribes a second one - in two or three weeks.
The study should be repeated regularly, even if no abnormalities were found.