WES sign: Difference between revisions

(porcelain gallbladder)
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==Background==
==Background==
The "wall echo shadow" (WES) sign is observed in patients with a contracted gallbladder around a large gallstone.  There are two parallel hyperechoenic lines (Wall) separated by a hypoechoic space (Echo), and distal shadowing (Shadow) from the gallstone.  Patients with multiple gallstones can also produce the finding if the gallbladder is contracted around them.  The sign can distinguish a gallstone from a loop of bowel when the entirety of the gallbladder is not visible due to the large shadowing.  <ref>Rybicki FJ. The WES sign. Radiology. 2000;214 (3): 881-2[http://pubs.rsna.org/doi/pdf/10.1148/radiology.214.3.r00mr38881 PDF]</ref><ref>Macdonald F. et al. The WES triad - a specific sonographic sign of gallstones in the contracted gallbladder. Gastrointest Radiol. 1981;6 (1): 39-41</ref>
The "wall echo shadow" (WES) sign is observed in patients with a contracted gallbladder around a large gallstone.  There are two parallel hyperechoenic lines (Wall) separated by a hypoechoic space (Echo), and distal shadowing (Shadow) from the gallstone.  Patients with multiple gallstones can also produce the finding if the gallbladder is contracted around them. It can also be seen in a "porcelain gallbladder." The sign can distinguish a gallstone from a loop of bowel when the entirety of the gallbladder is not visible due to the large shadowing.  <ref>Rybicki FJ. The WES sign. Radiology. 2000;214 (3): 881-2[http://pubs.rsna.org/doi/pdf/10.1148/radiology.214.3.r00mr38881 PDF]</ref><ref>Macdonald F. et al. The WES triad - a specific sonographic sign of gallstones in the contracted gallbladder. Gastrointest Radiol. 1981;6 (1): 39-41</ref>


==Images==
==Images==

Revision as of 20:57, 21 May 2014

Background

The "wall echo shadow" (WES) sign is observed in patients with a contracted gallbladder around a large gallstone. There are two parallel hyperechoenic lines (Wall) separated by a hypoechoic space (Echo), and distal shadowing (Shadow) from the gallstone. Patients with multiple gallstones can also produce the finding if the gallbladder is contracted around them. It can also be seen in a "porcelain gallbladder." The sign can distinguish a gallstone from a loop of bowel when the entirety of the gallbladder is not visible due to the large shadowing. [1][2]

Images

"Wall Echo Shadow" (WES Sign) Non-obstructing gallstones within a contracted gallbladder

Instructions

Perform a Gallbladder Ultrasound

Sources

  1. Rybicki FJ. The WES sign. Radiology. 2000;214 (3): 881-2PDF
  2. Macdonald F. et al. The WES triad - a specific sonographic sign of gallstones in the contracted gallbladder. Gastrointest Radiol. 1981;6 (1): 39-41