Ultrasound Diagnosed Gallstones that were Radiolucent on a Recent CT ScanClinical HistoryA 55-year old lady presented with abdominal pain and tenderness in the right upper quadrant.Case DescriptionA contrast CT scan of the abdomen and pelvis was performed which revealed an inflamed gallbladder wall with no radio-opaque gallstone seen. However, ultrasound was recommended to rule out gallstones.Diagnosis/ Discussion/ Treatment/ Follow upThe patient had an uneventful laparoscopic cholecystectomy.Ultrasound is more sensitive in the diagnosis of cholelithiasis than CT scan. Some gallbladder calculi (cholelithiasis) can be radioluscent, therefore missed on CT. This is why abdominal ultrasound is the recommended first line of imaging, when it is available, for cases with clinically suspected cholelithiasis.Sonograms B-mode image showing the gallbladder containing some calculi B-mode image of the gallbladder calculus impacted in the gallbladder neckLongitudinal view of the normal common bile ductB-mode image of the gallbladder showing an increased wall thickness of 5.5 mm in AP calibreAxial CT of the gallbladder performed just prior to ultrasound showing some wall inflammation, however, no radiopaque calculus was seenPublished on: September 25, 2024
