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Ultrasound signs of a normal gallbladder
Last reviewed: 04.07.2025
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In longitudinal sections, the gallbladder appears as an echo-negative pear-shaped structure. Its position, size and shape are very variable, but the width of a normal gallbladder rarely exceeds 4 cm.
The gallbladder has some mobility. It may be elongated and may be visible below the anterior superior iliac crest when scanning (especially when the patient is standing). It may be visible to the left of the midline. If the gallbladder is not visible in the normal position, examine the entire abdomen, starting with the right half.
The thickness of the gallbladder wall is measured on cross-sections; in patients who have not eaten, the wall thickness does not exceed 3 mm or less, and with tight filling of the gallbladder, the wall thickness is 1 mm.
If the gallbladder is not visualized in its usual position, examine the entire abdomen and pelvic area. If necessary, repeat the examination in 6-8 hours or ask a colleague to examine the patient.
The absence of visualization of the gallbladder during ultrasound examination does not mean that it is not there.
The normal right and left common hepatic ducts are not always easy to identify, but when they are visualized in the liver they appear as thin-walled tubular structures. However, the common bile duct can usually be visualized just anterior and lateral to the portal vein branching, and its cross-section at this level should not exceed 5 mm. The diameter of the common bile duct varies, but should not exceed 9 mm at its entry into the head of the pancreas.