Gallbladder polyp — Ultrasound (SRU 2022)

USSRU consensus 2022

Management of an incidentally detected gallbladder polyp on ultrasound.

Applies to

Incidentally detected gallbladder polyp on ultrasound

Does not apply to

Primary sclerosing cholangitis (refer to GI guidelines)
Findings suggestive of invasive malignancy (refer to oncologic specialist)

What to report

Tap an item to check it off while dictating.

1.Size and number
Largest polyp diameter, rounded to the nearest mm; number of polyps (multiplicity does not change risk).
Pitfall: Size overestimation drives overtreatment — measure carefully at the base.
2.Morphology
Pedunculated 'ball-on-the-wall'/thin stalk (extremely low risk) versus thick/wide stalk or sessile (low risk).
3.Adjacent wall
Focal wall thickening ≥4 mm adjacent to the polyp places it in the indeterminate-risk category.
4.Mobility and shadowing
Distinguish a polyp (fixed, non-shadowing) from a stone or tumefactive sludge ball (mobile, may shadow).
Pitfall: A mobile, shadowing, gravity-dependent focus is a stone or sludge ball — not a polyp.
5.Vascularity
May help distinguish polyp from sludge, but vascularity does not change SRU risk stratification.

Scores & calculators

Gallbladder polyp management

SRU consensus 2022 (Kamaya et al.)

Management of an incidentally detected gallbladder polyp on ultrasound, stratified by morphology and size. Does not apply to primary sclerosing cholangitis (refer to GI guidelines).

Morphology (risk category)

Pedunculated 'ball-on-the-wall' or thin stalk — extremely low riskPedunculated thick/wide stalk, or sessile — low riskFocal wall thickening ≥ 4 mm adjacent to the polyp — indeterminate risk

Size

≤ 6 mm7–9 mm10–14 mm≥ 15 mm

Complete the inputs to see the result.

Sources

SRU gallbladder polyp consensus — Kamaya A et al. Radiology (2022)

Content review: Content pending clinical review · 2026-07-09

Educational reference for trained clinicians. Verify every result against the cited original guideline before use. Not a substitute for clinical judgment or medical advice.