Acute cholecystitis

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[edit] Discussion of Acute cholecystitis

  • Acute cholecystitis is the most common cause of acute pain in the right upper quadrant (RUQ).
  • Urgent surgical removal of the gallbladder is the treatment of choice for uncomplicated disease.
  • Ninety percent to 95% of cases are due to calculous obstruction of the gallbladder neck or cystic duct leading to increased intraluminal pressure and distention.
  • Inflammation may result from chemical injury of the mucosa by bile salts and/or superimposed infection.
  • Gallbladder ischemia and transmural necrosis may occur if the obstruction persists.


[edit] Imaging Findings for Acute cholecystitis

[edit] US

  • Tensely distended gallbladder
  • Most sensitive US finding in acute cholecystitis is the presence of cholecystolithiasis in combination with the sonographic Murphy sign.
  • Both gallbladder wall thickening (>3 mm) and pericholecystic fluid are secondary findings that are neither sensitive nor specific for acute cholecystitis.
  • Every effort should be made to demonstrate the obstructing stone in the gallbladder neck or cystic duct.

[edit] DISIDA Scan

  • Nonvisualization of the gallbladder

[edit] Images

Patient #1: CT demonstrates findings that are consistent with acute cholecystitis (gallstone in GB neck, perichol fluid, GB wall thickening)

Patient #2: MR images demonstrates findings that are consistent with acute cholecystitis (perichol fluid, GB wall thickening)

[edit] See also

[edit] External Links

[edit] References for Acute cholecystitis