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The concept of real numbers includes all the values that can be represented on a continuous number line. The system began with basic counting values used for enumeration. It later expanded to include values that represent the absence of quantity and opposites of the counting values. When situations required expressing parts of a whole or dividing quantities evenly, values capable of representing such proportions were developed. When written using decimal notation, these values can end or repeat...
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Polynomials are algebraic expressions of terms with variables raised to non-negative integer powers. A central aspect of analyzing polynomial functions is determining their real zeros—values of the variable for which the polynomial evaluates to zero. These values represent the x-intercepts of the polynomial’s graph.The Rational Zeros Theorem lists possible rational solutions for a polynomial equation with integer coefficients. If f(x)=anxn+....+a0​, then every rational zero is...
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The unit circle—a circle with a radius of one, centered at the origin of the coordinate plane—serves as the foundational framework for defining trigonometric functions. In this context, arc length refers to the distance measured along the circumference of the circle between two points, and it provides a way to represent real numbers geometrically. Each real number t corresponds to an arc length measured counterclockwise from the positive x-axis around the circle. The coordinates of...
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Gallbladder Polyps: Real or Imagined?

Yiping Li1, Talar Tejirian, J Craig Collins

  • 1Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA.

The American Surgeon
|February 13, 2019
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Summary
This summary is machine-generated.

Ultrasound often misidentifies gallbladder stones or sludge as polyps. True gallbladder polyps are rare, with a very low risk of cancer, but size and patient age are key factors.

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Area of Science:

  • Gastroenterology
  • Diagnostic Imaging
  • Surgical Pathology

Background:

  • Gallbladder polyps detected via imaging studies necessitate further investigation.
  • Discrepancies between imaging findings and final pathology are common for gallbladder lesions.

Purpose of the Study:

  • To compare preoperative ultrasound (US) findings of gallbladder polypoid lesions with postoperative pathologic diagnoses.
  • To inform clinical decision-making regarding the management of suspected gallbladder polyps.

Main Methods:

  • Retrospective review of adult patients who underwent cholecystectomy for US-diagnosed gallbladder polyps between 2008 and 2015.
  • Manual review of imaging data, final pathology reports, and patient demographics.

Main Results:

  • Of 2290 patients with US-identified polyps, 73% had no polyps on final pathology (stones/sludge most common).
  • Pathologic polypoid lesions were found in 24.2% of patients, including cholesterol polyps (20.2%), other benign types (1.8%), adenomas (1.7%), and adenocarcinomas (0.4%).
  • All adenocarcinomas occurred in patients over 40 years old, with 91% having US polyp findings >10 mm.

Conclusions:

  • Ultrasound is an unreliable modality for definitively detecting true gallbladder polyps.
  • The risk of gallbladder cancer among sonographically detected polyps is very low.
  • Patient age and polyp size on ultrasound are critical factors in selecting surgical candidates.