What ultrasound findings are typically evaluated when biliary disease is suspected?

• A. Gallstones, gallbladder wall thickening, pericholecystic fluid, CBD dilation; sonographic Murphy sign
• B. Kidney size and echotexture
• C. Spleen size
• D. Pancreatic enlargement

Answer: (A)

When biliary disease is suspected, ultrasound focuses on the gallbladder and biliary tree to look for stones, inflammation, and obstruction. Gallstones appear as bright echoes within the gallbladder that cast a posterior shadow. The gallbladder wall thickening, usually greater than about 3 mm, points to inflammation, and when you see fluid around the gallbladder (pericholecystic fluid), it supports acute cholecystitis. If the common bile duct is dilated, that suggests obstruction somewhere along the biliary tree, such as a stone in the duct or a mass, and the diameter is measured to assess significance. A positive sonographic Murphy sign—tenderness elicited when the ultrasound probe compresses the gallbladder—also strengthens the suspicion for acute cholecystitis.

These findings together are the most informative for biliary pathology. Other choices don’t fit the context: examining kidney size or echotexture relates to renal disease, spleen size to splenic issues, and pancreatic enlargement points more to pancreatic problems rather than primary biliary disease.