THE CONTRACTED OR SMALL GALLBLADDER

Postprandial The most likely cause is physiological and due to inadequate preparation. The normal gallbladder wall is thickened when contracted, and this must not be confused with a pathological process. Always enquire what the patient has recently eaten or drunk (Fig.BELLOW).

Pathological causes of a small gallbladder Most pathologically contracted gallbladders contain stones. When the gallbladder cannot be identified, try scanning transversely through the gallbladder fossa, just caudal to the porta hepatis. Strong shadowing alerts the sonographer to the possibility of a contracted gallbladder full of stones. The reflective surface of the stones and distal shadowing areBapparent and the anterior gallbladder wall can be demonstrated with correct focusing and good technique (Fig. Bellow)

Do not confuse the appearances of a previous cholecystectomy, when bowel in the gallbladder fossa casts a shadow, with a contracted, stone-filled
gallbladder. A less common cause of a small gallbladder is the microgallbladder associated with cystic fibrosis (Fig. bellow).

The gallbladder itself is abnormally small, rather than just contracted. Cystic fibrosis also carries an increased incidence of gallstones because of the altered composition of the bile and bile stasis and the wall might be thickened and fibrosed from cholecystitis. ultrasound images of cholecystitis, ultrasound images of Cystic fibrosis, ultrasound images of gallbladder

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