Test yourself
Gallbladder wall: thick does not equal cholecystitis
4 questions. Pick an answer to see whether you are right and why. Your score appears at the end.
Question 1What is the upper limit of normal for gallbladder wall thickness?
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Answer d. A wall over 3 mm counts as thickened. Measure the anterior wall with the beam at 90° to it, because oblique cuts exaggerate thickness.
Question 2Which wall of the gallbladder do you measure?
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Answer a. The anterior wall sits against the liver and has a clean edge. The posterior wall blends with bowel and its gas, which makes it look thicker than it is.
Question 3A patient with heart failure and ascites has a 6 mm smooth gallbladder wall, no stones and no focal tenderness. What is the best interpretation?
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Answer c. Systemic venous congestion and low oncotic pressure thicken the wall. Without stones, focal tenderness or pericholecystic fluid, the thick wall does not point to cholecystitis.
Question 4Which combination most strongly supports acute calculous cholecystitis?
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Answer d. Gallstones with focal tenderness under the probe give the strongest bedside pattern. Wall thickening and pericholecystic fluid add weight. A thick wall alone is non-specific.
Practise it with us
Four or five delegates per instructor, FAMUS-accredited faculty and long, supervised time on the probe.
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