Lee Cheng-Chi, Huang Jen-Chieh, Shin Jeng-Shiann, Wu Ming-Je
Department of Internal Medicine, Division of Gastroenterology, Cheng Ching General Hospital, Taichung, Taiwan.
Department of Surgery, Cheng Ching General Hospital, Taichung, Taiwan.
J Med Ultrasound. 2018 Apr-Jun;26(2):103-106. doi: 10.4103/JMU.JMU_19_18. Epub 2018 Jun 12.
Biliary sludge (or very thick bile) is mainly comprised of calcium bilirubinate granules and lesser amounts of cholesterol crystals, and it can produce a layer of low amplitude of echoes in the most dependent part of the gallbladder (GB). In tumefactive biliary sludge, low-amplitude echoes do not form a fluid-fluid level but instead tend to give the appearance of a polypoid mass that is bounded by a smooth margin, round, and lobulated. Differential diagnoses for an echogenic mass in the GB lumen include GB carcinoma, tumefactive sludge, and gangrenous cholecystitis. In this case report, we describe a rare case in which biliary sludge did not form a fluid-fluid level but tended to accumulate and appear as a polypoid mass within the lumen of the GB. The lesion was finally identified as being tumefactive sludge mimicking neoplasm of the GB.
胆泥（或非常浓稠的胆汁）主要由胆红素钙颗粒和少量胆固醇结晶组成，它可在胆囊（GB）最靠下的部分产生一层低回声。在肿胀性胆泥中，低回声不会形成液-液平面，而是倾向于呈现出一种息肉样肿物的外观，其边界光滑、圆形且分叶状。胆囊腔内强回声肿物的鉴别诊断包括胆囊癌、肿胀性胆泥和坏疽性胆囊炎。在本病例报告中，我们描述了一例罕见病例，其中胆泥未形成液-液平面，而是倾向于积聚并在胆囊腔内表现为息肉样肿物。该病变最终被确定为模仿胆囊肿瘤的肿胀性胆泥。
