Copyright 2008
RUQ Pain, Distended Gallbladder, Indurated Fat |
| 77717c02s right upper quadrant pain ICU setting RUQ pain gallbladder distended thick walled hyperemic enhancing wall pericholecystic induration dirty fat stranding acalculous cholecystitis Courtesy Ashley DAvidoff MD copyright 2008 |
RUQ Pain, Distended Gallbladder, Tumefactive Bile – same patient |
| 77717c01s right upper quadrant pain ICU setting RUQ pain gallbladder distended thick walled sludge cholestasis tumefactive bile fluid in gallbladder fossa small shadowing stones acalculous cholecystitis shape of tumefactive bile in the gallbladder has fetus like formation USscan ultrasound Courtesy Ashley DAvidoff MD copyright 2008 |
Pear Shaped |
| 47018 gallbladder normal shape pear shaped anatomy nrmal USscan Davidoff MD |
Pear |
| 85370pb01.8s pear fruit food gallbladder shape Davidoff photography Davidoff art Copyright 2008 |
Tear Drop |
| 02504pb03 water droplets window glass teardrop shape Davidoff photography water |
Normal Fasting Gallbladder |
| 18138c.81s gallbladder fasting normal size about 100ccs fluid secretions in the stomach anatomy size physiology function shape position character water density CTscan Courtesy Ashley Davidoff MD copyright 2008 |
Phrygian cap
The phrygian cap is a common normal variant of gallbladder shape characterized a fundus that is folded forward. It was first described by Bartel in 1916. The Phrygians were a primitive race that migrated into northern and central Asia Minor in the second millenium BC. The Greeks knew of the cap as an Oriental headgear that was tight fitting and conical in shape and it has been depicted in their art. (Ober WB, Wharton RN On the “phrygian cap.” 255:571-572 New England Journal of Medicine 1956
Phrygians of Northern and Central Asia Minor 1000-2000BC |
| 82407b14.8s gallbladder Phrygian cap freedom liberty shape symbol Davidoff art Copyright 2008
The phrygian cap is a common normal variant of gallbladder shape characterized a fundus that is folded forward. It was first described by Bartel in 1916. The Phrygians were a primitive race that migrated into northern and central Asia Minor in the second millenium BC. The Greeks knew of the cap as an Oriental headgear that was tight fitting and conical in shape and it has been depicted in their art. (Ober WB, Wharton RN On the “phrygian cap.” 255:571-572 New England Journal of Medicine 1956 The cap was a symbol of freedom and the pursuit of liberty. The cap was worn by King Midas who was cursed with donkey ears by Apollo. He used the Phrygian cap to hide his ears. It was subsequently worn by the Trojan hero Paris, was a symbol of freedom in the French and American revolutions, was depicted on coinage in the US and on variety of seals and flags throughout the world. |
The cap was a symbol of freedom and the pursuit of liberty.
The cap was worn by King Midas who was cursed with donkey ears by Apollo. He used the Phrygian cap to hide his ears. It was subsequently worn by the Trojan hero Paris, was a symbol of freedom in the French and American revolutions, was depicted on coinage in the US and on variety of seals and flags throughout the world.
Phrygian cap |
| 45217 gallbladder shape phrygian cap normal anatomy shape USscan Courtesy Ashley Davidoff MD |
 
Phrygian cap |
| 39696 39696b Courtesy Ashley Davidoff MD gallbladder normal anatomy shape phrygian cap |
Reversed Phrygian |
| 82447c01.81s 67 F gallbladder reversed phrygian cap kidney ptotoc prominent artery and veins probable AVM arteriovenous malformation CTscan Corteys Ashley DAvidoff MD copyright 2008 |
Enlarged with Phrygian Cap – Cholestasis |
| 18260.8s gallbladder shape phrygian cap distended enlarged courtesy Ashley Davidoff MD copyright 2008 |
Fundal Fold Phrygian Cap |
| 04487.8s gallbladder fundus fold normal variant anatomy shape OCG Courtesy Ashley DAvidoff MD copyright 2008 |
Fold in the Fundus Phrygian in Green |
| 04487.84s.8s gallbladder fundus fundal fold fold normal variant anatomy shape cystic duct phrygian cap Davidoff art copyright 2008 |
Fold in the Fundus |
| 82698.8s 69F shape fold in the fundus gallbladder normal variant anatomy Courtesy Ashley Davidoff MD copyright 2008 |
Sigmoid Shape
“S” shaped Gallbladder |
| 28470 gallbladder normal shape S-shape anatomy USscan Davidoff MD |
Sigmoid Gallbladder |
| 82453c01.8s 88F p/w abdominal pain no known prior study gallbladder shape character sinusoidal shape to “s” shape fluid fluid level milk of contrast bile vicarious excretion anatomy CTscan Courtesy Ashley DAvidoff MD |
Elongated but not Dilated – The Aging Gallbladder |
| 76764.8s elderly femal gallbladder elongated sausage shape zuchini shape transverse dimension 4.5 cms longitudinal dimension 12.5cms aging gallbladder vs enlarged? CTscan Courtesy Ashley DAvidoff MD copyright 2008 |
Zuchini Gallbladder |
| 76764c.81s elderly female gallbladder elongated sausage shape zuchini shape transverse dimension 4.5 cms longitudinal dimension 12.5cms aging gallbladder vs enlarged? food in the body CTscan Courtesy Ashley DAvidoff MD Davidoff art Davidoff photography copyright 2008 |
Fold in Fundus Oral Cholecystogram |
| 04407 gallbladder filling defect stones cholelithiasis OCG oral cholecystogram imaging radiology historical |
Figure of 8 Chronic Cholecystitis |
| 04731.8s gallbladder fibrosis across the fundus filling defect chronic cholecystitis OCG historical stricture Courtesy Ashley Davidoff MD copyright 2008 |
Figure of 8 Chronic Cholecystitis |
| 11530.81s gallbladder fibrosis across the fundus filling defect chronic cholecystitis cholelithiasis stone in fundus OCG historical stricture Courtesy Ashley Davidoff MD copyright 2008 |
Chronic Cholecystitis |
| 31285.8s 64 male gallbladder fibrosis across the fundus filling defect chronic cholecystitis cholelithiasis stone in fundus Ctscan figure of eight stricture Courtesy Ashley Davidoff MD copyright 2008 |
Pear Shaped Gallbladder |
| 17082b01.8s gallbladder + fx distended + wall edema dx distal common bile duct stone imaging radiology MRI |
Porcelain Gallbladder |
| 47683c01 gallbladder fx calcification in wall calcified wall dx porcelain gallbladder CTscan Davidoff MD |
Chronic Cholecystitis Focal Fibrosis |
| 11530.81s gallbladder shape deformity filling defect figure of eight defect cholelithiasis chronic cholecystitis oral cholecystogram historical Courtesy Ashley DAvidoff MD copyright 2008 |
Metastasis to Fundus |
| 22705 gallbladder abdomen peritoneum peritoneal cavity fx mass fx calcification fx distortion dx metastatic colon carcinoma large bowel malignant primary compliacated by transperitoneal spread dx metastasis to the gallbladder fundus metastases metastattic fx ascites imaging radiology CTscan C+ CTscan Courtesy Ashley Davidoff MD |
Metastasis to Fundus |
| 22704c01.8s gallbladder abdomen peritoneum peritoneal cavity fx mass fx calcification fx distortion dx metastatic colon carcinoma large bowel malignant primary compliacated by transperitoneal spread dx metastasis to the gallbladder fundus metastases metastattic fx ascites imaging radiology CTscan C+ CTscan Courtesy Ashley Davidoff MD copyright 2008 |
Biloculate Carcinoma of the Fundus Mucosal and Submucosal Infiltration |
| 16228c01.8s gallbladder wall submucosal tumor = orange mucosal tumor = pink lumen = green thickened mucosa and submucosa carcinoma of the gallbladder CTscan Courtesy Ashley DAvidoff MD copyright 2008 |
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Pseudocyst Masquearding as a Distended Gallbladder |
| 40219c01 40222c Courtesy Ashley Davidoff MD code pancreas fx peri pancreatic induration exudate code liver gallbladder fx cystic mass dx pseudocyst subacute pancreatitis imaging radiology CTscan code inflammation |
