Limy Bile Syndrome on POCUS



You are performing a POCUS GB exam on elderly woman and notice the following in the GB lumen (hyperechoic layer with posterior shadowing).  What is it?  Sludge? 

Answer:  Milk of calcium bile-also known as limy bile.  Pasty, semisolid substance-Ca carbonate. Usually associated with GB stasis.Rarely known to cause cholecystitis or move into CBD. 



CT Correlate: https://twitter.com/RJonesSonoEM/status/1219390014758498309



Dr. Robert Jones @RJonesSonoEM



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