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