- Ultrasound is best initial investigation – definitive in 80% cases
- 90-95% of cases of cholecystitis due to stones
Imaging
- USG
- Gall bladder wall thickness > 3 mm has 95% positive predictive value
- Gall bladder distension (diameter >5 cm)
- Pericholecystic fluid
- Gall bladder wall striations
- Wall hyperemia occasionally on Doppler
- If labs show signs of cholestasis, rule out CBD stone
- CT
- Less accurate
- Gall bladder wall thickening
- Subserosal edema
- Gall bladder distension
- High-density bile
- Pericholecystic fluid
- Inflammatory stranding in pericholecystic fat
Read more
Altun, Ersan, et al. “Acute cholecystitis: MR findings and differentiation from chronic cholecystitis.” Radiology 244.1 (2007): 174-183.
Hanbidge, Anthony E., et al. “From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant.” Radiographics 24.4 (2004): 1117-1135.
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