Biliary Microlithiasis

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Biliary Microlithiasis - Theories

Our Objective

We believe we detected Biliary Microlithiasis in the Gallbladder for the first time, using a simple unique Rapid Patient Rotation Ultrasound Protocol as part of a routine medical ultrasound... [ more ]

Treatment

Our experience suggests a fat free diet in some reduces and may resolve RUQ. Foci seem to resolve spontaneously in some. Perhaps it is because there is patient recognition that fat reduction improves symptoms... [ more ]

Rapid Patient Rotation Protocol

The Patient Rotation technique requires a voluntary patient rotation as rapid as possible with instantaneous visualization of the gallbladder immediately at the end of a rotation. Rotations are listed in order of effectiveness... [ more ]

Technical Considerations

Sequential unselected patients fasted and prepped for routine abdominal ultrasound. The voluntary Rapid Patient Rotation Protocol of the gallbladder was added to each exam. Prior to rapid rotation, the patient is held in a stationary position for a variable time or if prone subjected to a slow rocking motion within a limited arc... [ more ]

Theories

How Foci Cause Medical Disorders

Foci rapidly free fall in bile after disturbance suggesting their heavy density compared to bile. Not commonly seen on routine gallbladder ultrasound because they do not shadow and blend in with the dependent gallbladder wall, slow rotation will not stir them up, the transducer is not positioned on the gallbladder immediately after rotation and they can be obscured by an inappropriate ultrasound technique... [ more ]

Where Foci (Biliary Microlithiasis) Form

Most cystic ducts are smooth. Some have varying lengths of small corrugated saccule like dilatations along the duct wall, valves of Heister. Perhaps foci form in these corrugated sacculations... [ more ]

Results

Unselected sequential patients for routine abdominal ultrasound had all gallbladders examined using the rapid patient rotation. Intraluminal gallbladder echogenic foci were demonstrated in 294 out of 3820 patients examined, representing an incidence of 7.7%... [ more ]