Critical Care Ultrasonography > Chapter 23. Ultrasound Evaluation of the Abdomen Alan Cook,  Heidi L. Frankel

Biliary Ultrasound

"Far more useful to the intensivist is ultrasound imaging of the biliary tree and, to a lesser extent, the pancreas. Typically, ICU patients are imaged in the supine position and enteral feeds are continued. A longitudinal-axis view of the gallbladder with the common bile duct present anterior to the portal vein is seen in Figure 23.19. This approach provides the intensivist with important answers to the following questions: Does the jaundiced patient have gallstones or sludge, or is acalculous cholecystitis present? Is there evidence of ductal dilatation and choledocolithiasis? Does the septic patient have features of acute cholecystitis (either calculous or not) such as a sonographic Murphy's sign, gallbladder wall thickening, and pericholecystic fluid? Is there a mechanical reason for jaundice?..."