To review the pathophysiology and diagnostic workup of acute biliary diseases. To illustrate the imaging findings of biliary disorders seen in the emergency setting.

Biliary disorders are among the most common reasons for patients with acute abdominal pain to seek medical care. Acute cholecystitis typically is the first diagnosis considered in patients presenting with right upper quadrant pain. Approximately 90-95% of acute cholecystitis are related to gallstone impactation in the cystic duct or gallbladder neck, resulting in outflow obstruction of the gallbladder and associated luminal distention. Increasing gallbladder distention and subsequent intraluminal pressure leads to irritation of the gallbladder mucosa and venous and lymphatic congestion, leading to the release...

Specific diagnosis of acute biliary disease is not always possible clinically because of the overlapping signs and symptoms, such as right upper quadrant and epigastric pain, jaundice, and high fever.[2]Thus, imaging plays a key role in establishing a prompt diagnosis and guiding the appropriate treatment. Ultrasonography (US) should be the first imaging modality performed in patients with suspected biliary disease. It has the advantages of being readily available and rapidly performed, involving no ionizing radiation, being able to confirm the presence of gallstones and detect...

Acute biliary pathology is very common. Imaging is a very important tool in the differential diagnosis and evaluation of the severity of the disease, so it’s mandatory that the radiologist is able to recognize the imaging features of the various biliary disorders, in order to establish the diagnosis and guide the treatment approach.

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