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Abdomen » Liver & Biliary System
Cholesterolosis of Gallbladder
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Author(s) :
Ross Wank, MD  |  Rafay Ahmed, MD
 
Presentation A 39 Year old female presented with right upper abdominal pain.
 
 
 
Caption: Saggital Sonogram of Liver and Gallbladder.
Description: Saggital view of gallbladder showing multiple, echogenic, non-shadowing, polypoid defects along the anterior gallbladder wall, typical of cholesterol polyps. These show typical ‘ring-down’ artifacts. There is also gallbladder wall thickening, with multiple stones in the fundus, producing posterior shadowing.
 
 
 
Caption: Saggital Sonogram of Gall Bladder
Description: Saggital view of the same gallbladder slightly lateral to the previous image showing polyps along the anterior wall, with multiple stones and sludge in the gallbladder neck.
 
 
 
Caption: Transverse Sonogram of GallBladder
Description: Visible in this Tranverse view again are small polyps attached to the anterior gallbladder wall, producing "Ring Down" artifact.
 
 
 
Caption: Transverse Sonogram of Gallbladder with Color Doppler Imaging
Description: Color Doppler Imaging of the polyps shows "Twinkle Artifact". Twinkling artifact may be seen with color doppler imaging of renal calculi, gallbladder stones, and cholesterol crystals in the gallbladder.
 
 
 
Caption: Saggital View of Gallbladder with Color Doppler
Description: Color Doppler imaging shows a "Twinkle Artifact".This should not be mistaken for flow within the polyp.
 
Differential Diagnosis Cholesterolosis
Adenomyomatosis
Cholelithiasis
Cholecystitis
 
Final Diagnosis Cholesterolosis with Gall Bladder Stones
 
Discussion
A detailed discussion about  Cholesterolosis is available at the following link on Sonoworld http://sonoworld.com/Client/Articles/ArticleDetails.aspx?ArticleId=5
 
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