Acute cholecystitis echocardiography and ultrasound
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Transabdominal ultrasound is the initial test of choice for the diagnosis of acute cholecystitis. Findings on an ultrasound diagnostic of acute cholecystitis include thickened gallbladder, gallstones or sludge, and pericholecystic fluid.
- Transabdominal ultrasonography is the initial test of choice for the diagnosis of acute cholecystitis and gallstones.
- Acute calculous cholecystitis is diagnosed radiologically by the presence of
- Thickening of gallbladder (5mm or greater)
- Pericholecystic fluid
- Probe tenderness (ultrasonographic Murphy's sign)
The ultrsound based diagnostic criteria from multiple studies for acalculous cholecystits is as follows.
|Major||3.5 to 4 mm (or more) thick wall (if at least 5 cm distended longitudinally with no ascites or hypoalbuminemia)|
Pericholecystic fluid (halo)/subserosal edema
Sloughed mucosal membrane
|Minor||Echogenic bile (sludge)|
Hydrops = distension greater than 8-cm longitudinally or 5-cm transversely (with clear fluid)
Diagnosis: 2 major or 1 major and 2 minor (most studies have favored the diagnostic triad: wall thickness, sludge, hydrops).
Advantages of ultrasound
- Advantages of ultrasound include:
- Quick and readily available
- Relatively inexpensive
Limitations of ultrasound
- Limitations of ultrasound include:
- Poor visualization with intraluminal gas between probe and gallbladder
- "Gallbladder, Cholecystitis, Acute - StatPearls - NCBI Bookshelf".
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