Wall-echo-shadow sign (ultrasound)

The wall-echo-shadow sign (also known as WES sign) is an ultrasonographic finding within the gallbladder fossa referring to the appearance of a "wall-echo-shadow":

• a curvilinear hyperechogenic line representing the gallbladder wall
• a thin hypoechoic space representing a small amount of bile
• a curvilinear hyperechogenic line representing the near surface of gallstone(s)
• and acoustic shadowing distal to the surface of the gallstone(s)

The sign suggests either a large gallstone or multiple small gallstones filling the lumen of a contracted or incompletely visualized gallbladder. Recognizing this finding helps to avoid misinterpretation of a stone-filled gallbladder as a loop of bowel .

Differential diagnosis

• air-filled loop of bowel
• porcelain gallbladder: lacks the thin hypoechoic bile space between the wall and gallstone, as seen in the wall-echo-shadow sign
• emphysematous cholecystitis

Siehe auch:

• Cholezystolithiasis

und weiter:

• Porzellangallenblase