Incidental Gallbladder Polyp / Biliary Dilation
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SRU 2022 (polyps) · ACR IFC 2013 (biliary)·reviewed 2026-07-02
- •Gallbladder-polyp thresholds follow the 2022 SRU consensus, which is less aggressive than older schemes: the surgical-consultation size is ≥15 mm (not 10 mm), and true polyps <10 mm are usually benign cholesterol polyps.
- •A pedunculated polyp ≤9 mm with a thin stalk or 'ball-on-the-wall' morphology is 'extremely low risk' and needs no follow-up regardless of the size branch below.
- •Distinguish a polyp (immobile, no shadowing, may show a vascular stalk) from adherent stone/sludge (mobile, shadowing) before applying this pathway.
What is the incidental finding?
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Sources
- Kamaya A, et al. Management of Incidentally Detected Gallbladder Polyps: Society of Radiologists in Ultrasound Consensus Conference Recommendations. Radiology. 2022;305(2):277-289.
- Sebastian S, et al. Managing Incidental Findings on Abdominal and Pelvic CT and MRI, Part 4: White Paper of the ACR IFC II on Gallbladder and Biliary Findings. J Am Coll Radiol. 2013;10(12):953-956.
Educational reference for clinicians — not medical advice. Verify against the primary source before acting on it; guidelines change. Final decisions rest with the interpreting physician and your institution's protocols.