WES sign


  • "Wall Echo Shadow" (WES) sign
  • Consists of two parallel hyperechoenic lines (Wall) separated by a hypoechoic space (Echo), and distal shadowing (Shadow) from the gallstone.
    • Typically observed in patients with a contracted gallbladder around a single large gallstone
    • Patients with multiple gallstones can also produce the finding if the gallbladder is contracted around them
    • Can also be seen in a "porcelain gallbladder"
  • The WES 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