Floating stones in a nonopacified gallbladder: Ultrasonographic sign of gas-containing gallstones

Strijk, S. P.; Boetes, C.; Rosenbusch, Gerd

doi:10.1007/bf01890262

Cited by 8 publications

(5 citation statements)

References 7 publications

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“…These fissures may then become radiologically visible as radiolucent, radiating lines, the so-called Mercedes Benz sign [3,4,6]. This phenomenon may lead to uncommon manifestations such as spontaneous disintegration [4], floating in nonopacified bile due to an abnormally low specific gravity of the stones [2], and typical appearance on computed tomography and ultrasound [7].…”

Section: Discussionmentioning

confidence: 99%

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Calcified gallstone fissures: The reversed mercedes benz sign

Strijk

1987

Gastrointest Radiol

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Section: Discussionmentioning

confidence: 99%

“…Despite the frequency of cholelithiasis, however, some unusual features of gallstones attract attention. These include the phenomena of floating gallstones as well as spontaneous fissure formation and disintegration [1][2][3][4]. The case we present illustrates another uncommon appearance.…”

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confidence: 83%

Calcified gallstone fissures: The reversed mercedes benz sign

Strijk

1987

Gastrointest Radiol

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“…Gallstones appear as an accumulation of high-level echoes and cast an acoustic shadow due to sound absorption, regardless of their size, shape, surface characteristics, composition, or presence of calcium [8,9]. Floating gallstones have been observed on real-time sonography after contrast cholecystography and in 2 reported cases of gas-containing gallstones without previous cholecystography [10,11]. To our knowledge, the phenomenon of reproducible high-level echoes within the acoustic shadow of a gallstone at a perpendicular transducer position as observed in Patients 1-3 (Table 1) has not yet been reported.…”

Section: Discussionmentioning

confidence: 99%

Appearance of gas-containing gallstones on sonography and computed tomography

Becker

Vock

1984

Gastrointest Radiol

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The diagnostic features of gas-containing gallstones on sonography and CT in 6 patients and the in vitro findings in 30 gas-containing gallstones are analyzed. On plain abdominal radiography, the stellate appearance of gas collections, though infrequent, is quite characteristic. On real-time sonography, gas-containing calculi can be observed to float within bile. Furthermore, larger gas collections within gallstones can be identified since they produce high-level echoes in the acoustic shadow of the stone, probably due to sound reverberation. These phenomena, although interesting, do not interfere with the high accuracy of sonography in the detection of gallstones. CT detects gallstones when their density differs from that of bile. Due to high-density resolution, even minute gas collections are displayed and can reveal gallstones with an isodense matrix. However, under routine abdominal scanning conditions (8 mm collimation), the gas collections often appear round or ovoid, because spatial resolution is inferior to that on plain radiography. This fact should be considered in the differential diagnosis of gas collections in the gallbladder region found on CT.

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“…Certain gallstones, however, have a lower specific gravity due to contained gas-an unusual phenomenon known radiographically as the Mercedes-Benz sign; floating of these calculi has been demonstrated sonographically, with a configuration that simulates a fluid-fluid level. 6 A more common cause of floating gallstones occurs following gallbladder opacification in oral cholecystography. In fact, layering of calculi has long been recognized on cholecystograms of erect patients.…”

Section: Discussionmentioning

confidence: 99%