Learning objectives
- Discuss ecographic features of the different patterns of cholecystitis;
- Understand the overlapping clinical and ecographic features of the different patterns of cholecystitis;
- Describe the underlying pathophysiology of the sonographic features of the different patterns of cholecystitis;
- Discuss and describe the most frequent ecographic pitfalls of the different patterns of cholecystitis;
- Recognize the sonographic characteristics related to differential diagnosis of cholecystitis;
- Review the benefits and limitations of ultrasound in the emergent setting,
with emphasis on appropriate use of the modality...
Background
- The cholecystitis is any form of inflammation involving the gallbladder.
- Its epidemiology,
clinical presentation,
pathology and ecographic features are dependent on the actual aetiology.
- The cholecystitis can be classified into: acute cholecystitis (acute calculous cholecystitis and acute acalculous cholecystitis),
chronic cholecystitis,
emphysematous cholecystitis and xanthogranulomatous cholecystitis.
- Ultrasound is the primary imaging tool because it has high sensitivity in the detection of gallstones,
it allows an accurate assessment of intra and extrahepatic bile ducts,
and it can be done relatively quickly and...
Findings and procedure details
Acute cholecystitis (AC)
- AC is an acute inflammatory condition of the gallbladder(1);
- AC accounts 5% of the patients admitted in the emergency room with right upper quadrant pain (1);
- Most of the cases are related with the obstruction of the gallbladder by gallstones or with acalculous cholecystitis (2);
- Clinical presentation: right upper quadrant pain and tenderness(2);
- In the evaluation of the AC the ultrasound (US) is the initial imaging procedure(2);
- Computed Tomography (CT) is done initially if the cause...
Conclusion
This review provides greater confidence to the radiologist in the diagnosis of cholecystitis and in the recognition of its differential diagnosis.
The initial imaging modality should be ultrasound that is often sufficient for correct diagnosis.
Personal information
J.
C.
Ruivo Rodrigues,
B.
Rodrigues,
C.
F.
R.
C.
Ribeiro,
H.
Correia,
A.
Figueiredo,
N.
M.
P.
Ribeiro; Department of Radiology - Centro Hospitalar Tondela-Viseu,
directed by D.
Silva; Viseu/PT
References
(1) Khalili K.
WSR (2011).
In: Rumack C.M.
Wilson S.R.,
Charboneau J.W.,
(eds) Diagnostic Ultrasound.
St Louis: Elsevier-Mosby,
St Louis,
cp.6.
(2) Rubens DJ (2007) Ultrasound Imaging of the Biliary Tract.
Ultrasound Clinics 2:391-413.
(3) Teefey SA,
Baron RL,
Radke HM,
Bigler SA (1991) Gangrenous cholecystitis: new observations on sonography.
J Ultrasound Med 10:603-606.
(4) Gore RM,
Yaghmai V,
Newmark GM,
Berlin JW,
Miller FH (2002) Imaging benign and malignant disease of the gallbladder.
Radiol Clin North Am 40:1307-1323,
vi.
(5) Blankenberg F,
Wirth R,...