Unusual echographic appearance of a Courvoisier gall bladder

A patient who had been jaundice for more than four months was examined with diagnostic ultrasound. Ultrasound examination revealed that the patient had a solid-appearing mass in the region of the gall bladder, in addition to findings diagnostic of obstructive jaundice. A probable mass was also noted in the head of the pancreas. The clinical data and representative echographic pictures are presented to emphasize the point that sludge within the gall bladder is echogenic and appears more solid than cystic on a standard echographic examination.