Gallbladder carcinoma is rare and difficult to detect in the early stages of the disease process, due to lack of symptoms. Sonography is typically the first modality of choice for assessing gallbladder pathology due to its high sensitivity, portability, real-time imaging capability, and non-ionizing technique. Conventional gray-scale and color Doppler sonographic imaging may be ambiguous for diagnosing solid tumors, such as gallbladder carcinoma. In this case, gallbladder carcinoma was definitively diagnosed utilizing contrast-enhanced ultrasound, allowing for quick patient treatment options and an optimal surgical outcome.

Disclaimer: This informational resource is provided by the Society of Diagnostic Medical Sonography (SDMS) to facilitate discussion of complex issues affecting the diagnostic medical sonography profession. It is meant to help readers understand an issue, solve a problem, or make a decision. The information presented does not represent SDMS policy and should not be considered medical or legal advice. The reader should always consult a physician (for medical advice) or an attorney (for legal advice) licensed in their state to discuss their specific facts and circumstances before relying on the information provided in this document.

Gallbladder perforation is a rare and severe complication of acute cholecystitis. Sonography is typically the first modality of choice for assessing gallbladder pathology due to its high sensitivity, portability, real-time imaging capability, and nonionizing technique. Gray-scale and color Doppler sonographic imaging may be equivocal for diagnosing perforation. In the presented case, gallbladder wall perforation was definitively diagnosed utilizing contrast-enhanced ultrasound, allowing for prompt treatment and a successful patient outcome.

Hepatic artery pseudoaneurysms (HAPs) are rare, life-threatening complications that arise in response to liver trauma or underlying inflammatory processes. The risk of rupture necessitates prompt diagnosis and treatment. Sonography is an important imaging modality used to evaluate and characterize suspected HAPs. In the case described below, sonography played an important role in the diagnosis and successful treatment of a patient with a large, high-risk HAP.

Intestinal malrotation is a rare fetal anomaly resulting from the failure of midgut rotation and fixation. Sonography is typically the first modality of choice for assessing pediatric pathology due to its high sensitivity, portability, real-time imaging capability, and non-ionizing technique; however, its role in diagnosing small bowel rotational anomalies remains limited and controversial. Fluoroscopic upper gastrointestinal imaging (UGI) is the primary diagnostic examination at most institutions. However, even on UGI, imaging findings may be equivocal. In such cases, sonography may provide additional information at facilities where it is not used as a primary diagnostic tool. This case report represents the first reported case showing how patient position is important as the typical vascular sonographic features of rotation were normal in one position but abnormal in another. In addition, this case shows how congenital intestinal malrotation was decisively diagnosed using sonographic imaging.