WES sign represents well defined echogenic gall bladder wall
(W), echoes (E) from gallstones beneath gall bladder wall and prominent
posterior acoustic shadowing (S). Hypoechoic area beneath echogenic bladder
wall and calculi represent interpostioned bile. This sign is sufficient for diagnosis of
This sign suggests large gallstone or multiple small stones
filling the entire gall bladder lumen. If WES sign is not recognized, an gall
bladder may be misinterpreted as bowel loop.
Pitfalls are- Calcification of gall bladder wall as in
porcelain gallbladder and collapsed gallbladder and portion of duodenum appears
echogenic with posterior shadowing.