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The gallbladder lumen contains multiple internal echogenic foci. These echogenic foci appear non-dependent and are clustered, giving a speckled appearance. There is no clear posterior acoustic shadowing, which makes typical gallstones less likely. The gallbladder wall appears mildly thickened. The lumen does not appear completely anechoic; instead, it shows internal echoes Conclusion Gallbladder sludge with possible microlithiasis / biliary sludge balls, in the background of chronic cholecystiti
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