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The 'Reverse Decubitus' View: a Potential for Increasing the Sensitivity of Gallbladder Ultrasound

The purpose is to determine whether a variation of the standard decubitus patient positioning is of additional diagnostic value. Traditionally, the gallbladder is examined with the patient in the supine, right side up decubitus, erect and prone positions. However, with the patient in the left side up position a medial/cranial/oblique angulation of the transducer allows an additional acoustic window to the gallbladder fossa. As well as potentially demonstrating exquisite views of the gall bladder, it is asserted that previously unseen pathology may occasionally be detected. Thirty patients were examined using the routine patient positions and, in addition, the gallbladder was examined with each patient in the left side up position. In all cases, a longer axis was measurable with the patient left side up. In one case, pathology that was not appreciated in the routine patient positions was seen with the patient left side up. This study suggests that additional anatomical and pathological may be demonstrated by using the technique described.