Patient with RUQ abdominal pain. Difficulty finding GB. Pt denies history of prior abdominal surgery and no scars seen. See thread. #POCUS #IMPOCUS #FOAMed #FOAMus #MedEd #MedStudentTwitter @medpedshosp @NephroP @grepmeded @cianmcdermott @ACEP_EUS @PhilipsPOCUS
GB Sag and TRV sweeps. GB not seen. No surgical clips seen. Contracted GB, agenesis of GB, ectopic location of GB, prior removal (and patient forgot--it does happen)?
On Sag image, don't confuse bowel contents with GB filled with sludge 
During liver sweep to the right you notice the following on TRV/Sag clip. Appears to have ectopic GB location to far right. What additional diagnosis do you need to consider now?
Patients with ectopic GBs may remain asymptomatic or can develop cholecystitis, torsion, gangrene, or herniation depending on location. Sites include: intrahepatic, left-sided, floating, supra hepatic, retrohepatic, transverse.
While rare (0.1-0.7%), always consider ectopic GB when GB not found in traditional location. Need to consider additional diagnoses in these patients-torsion, gangrene, herniation. CT helpful in diagnosing these complications. Review article: epos.myesr.org/esr/viewing/?m…
