Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
167 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction

What does this ultrasound report indicate?

Answered by
Dr.
Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6675 Questions

default
Posted on Tue, 7 Jun 2016 in Liver and Gall Bladder
Question: Hello. Ultrasound of gb shows wall thickening of 3-4 mm. History of galkstones. Bile duct normal. Does this mean cholecystitis? US report suggests subacute
doctor
Answered by Dr. Vivek Chail 54 minutes later
Brief Answer:
A gall bladder wall thickness more than 3 mm is called cholecystitis

Detailed Answer:
Hi,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. A gall bladder wall thickness of more than 3 mm is thickened and called cholecystitis. Your gall bladder wall measures 3 to 4 mm in thickness and therefore can be called cholecystitis. Subacute is used because of your clinical symptoms.

2. Gall stones and a thick gall bladder wall is called calculus cholecystitis.

3. If there are multiple stones then the usual treatment is surgical removal of gall bladder.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Vivek Chail 1 hour later
So does this mean I have acute cholecystitis? Doctor who examined me ruled it out based on clinical symptoms, No severe pain when touching abdomen, negative XXXXXXX sign, no nausea. No Fever no loss of appetite, just tender achy area around ribcage. Does his ruling out acute cholecystitis make sense? Other finding to note in ultrasound is no free fluid. I think that is good sign, correct?

I am wondering and concerned if I am currently in an emergency situation or can Expect to be there in next few days if weeks in light of ultrasound findings. Will this mild wall thickening progress to full blown acute cholecystitis? I am worried because Oman to travel outside country XXXXXXX next week and wonder if I am ok to go on trip, or if too risky because this likely to get more serious?
doctor
Answered by Dr. Vivek Chail 17 minutes later
Brief Answer:
There is extremely low risk of transformation to acute cholecystitis

Detailed Answer:
Hi,
Thanks for writing back with an update.

1. Your doctor has given diagnosis of sub acute because the pain is mild and less than what is found in patients of acute cholecystitis.

2. No free fluid is a good sign and shows that your condition is mild.

3. The chances of serious problems is extremely low if you follow precautions suggested by your doctor.

4. You might be advised to have low oil foods and not to skip meals.

5. Going on a trip should not be a problem. However please keep your doctor informed of your travel plans.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Vivek Chail 1 hour later
I am having difficulty understanding difference between acute and subacute cholecystitis? Can you please explain.

So subacute is not precursor to acute ? Not is it a problem requiring urgent care? What would I look for as symptoms to suggest something more serious involving gallbladder such as acute inflammation infection or rupture? Is hit always a good sign that I have an Appetite? Is tho can indicator that condition is not serious. Not requiring emergency visit to hospital? I an planning to get elective surgery once I can schedule it but before then I still want to bd able to travel. Do basically you think I am safe with subacute? It should eventually resolve itself rather than get worse?
doctor
Answered by Dr. Vivek Chail 5 hours later
Brief Answer:
Most patients can be allowed to travel following medical treatment

Detailed Answer:
Hi,
Thanks for writing back with an update.

1. The definition of early acute cholecystitis is the presence of continuous clinical signs in the first 72 to 96 hours after the onset of symptoms. If the clinical signs persist or worsen beyond 72 to 96 hours after onset of symptoms then it is late acute cholecystitis or subacute cholecystitis.

2. Therefore acute and subacute are different presentations clinically.

3. Usually doctors suggest treatment for the above conditions and allow a cool down period of 6 to 12 weeks after sub acute cholecytitis, aftr this duration surgery is planned. Some surgeons however operate within 3 to 4 days of omnset of symptoms. The decision of when to do surgery is guided by medical research and the preference of the doctor.

4. Therefore in yourcase, I guess the doctor has treated you with medicines and plans to operate after 6 to 12 weeks and by then the gall bladder inflammation will come down.

5. Any serious complication of gall bladder will cause severe pain in right upper abdomen with guarding and rigidity, which can be signs of perforation. It will be seen on imaging studies. You do not have the signs and imaging features of all bladder complications.

6. Having appetite is always good but you should avoid too much of fat content in diet. This will help to avoid complications.

7. In my opinion, your doctor has treated you with medicines and now your gall bladder is recovering from inflammation. It is safe to plan a travel for few days in most patients having your condition. Avoiding excessive fats in diet and processed foods can prevent worsening. You can discuss your diet with a dietitian if possible, before going on your trip.

In conclusion, most patients can be allowed to travel following medical treatment in acute or subacute cholecystitis and a surgery planned in 6 to 12 weeks time. However, I suggest you another opinion from your doctor, since they are aware of your exact clinical condition.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Vivek Chail 41 hours later
They are not treating me with any medicine. But did suggest blood test to definitively rule out acute cholecystitis. CBC, liver enzymes and whatever else would indicate the condition. I should receive the results in a couple of days. Do you agree that this is will be a definitive test? I did a follow ultrasound to reassess and still shows mild thickening of gb wall 3-4 mm no bile duct dilatatitom, XXXXXXX gallstones. Does this still suggest subacute in your opinion? Doctor says clinically I do not appear to have acute cholecystitis based on symptoms but want to wait for blood test results to make sure I can travel. Does this make sense to you?
doctor
Answered by Dr. Vivek Chail 6 hours later
Brief Answer:
If liver enzymes and bilirubin are normal then there is no cholecystitis

Detailed Answer:
Hi,
Thanks for writing back with an update.

1. The blood tests will tell about any liver and biliary inflammation due to the gall stones. If liver enzymes and bilirubin is normal then the acute situation is not there and you can go on travel. Surgery can be planned when you get back.

2. The upper limit of normal gall bladder wall thickness is 3 mm and if the follow up ultrasound shows gall bladder wall thickness 3 to 4 mm then is recovering from the sub acute cholecystitis.

3. The nature of problem in gall bladder stone is mechanical and there is pain and inflammation when the stones get caught in the narrow areas of the biliary channels. I suggest you to take dietary precautions during your visit.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,  
Lab Tests
Medical Topics ,  

Recent questions on  Severe pain

doctor1 MD

Hi, My husband has pus filled pimples in the backside of his head. He has very oily hair. We have observed that they come up whenever he has sweets...

doctor1 MD

My father undergone Electrical cardioversion treatment due to having severe Atrial Fibrilation (AF). Needless to say the treatment did not work...

doctor1 MD

I have a severe pain in my right arm, actually in the muscle, upper arm... also started as a long standing fibromyalgia pain for years in shoulder...

doctor1 MD

If I might have had a heart attack 4 nights ago, should I go to emergency now? I have an appointment to see my doctor in 3 weeks. I'm 52 yr old...

doctor1 MD

Hello, my dr. Is out of of office for next week. Medical imaging called me to tell me that they picked up a 22 mm cyst on my left ovary . And a...

doctor1 MD

I HAD A THALAMUS STROKE IN SEPTEMBER. IT HAS LEFT ME WITH NEUROPATHY ON MY LEFT SIDE FROM MY SCALP TO THE BOTTOM OF MY FOOT, HAND BEING THE WORST....

doctor1 MD

Hello, my name is Michael Boswell. I am a 22 year old part-time student living with my mother. I am writing because I have been to one...