WES sign

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The "wall echo shadow" (WES) sign is observed in patients with a contracted gallbladder around a large gallstone. There are two parallel hyperechoenic lines (Wall) separated by a hypoechoic space (Echo), and distal shadowing (Shadow) from the gallstone. Patients with multiple gallstones can also produce the finding if the gallbladder is contracted around them. It can also be seen in a "porcelain gallbladder." The sign can distinguish a gallstone from a loop of bowel when the entirety of the gallbladder is not visible due to the large shadowing. [1][2]


"Wall Echo Shadow" (WES Sign) Non-obstructing gallstones within a contracted gallbladder

See Also


  1. Rybicki FJ. The WES sign. Radiology. 2000;214 (3): 881-2PDF
  2. Macdonald F. et al. The WES triad - a specific sonographic sign of gallstones in the contracted gallbladder. Gastrointest Radiol. 1981;6 (1): 39-41