Learning objectives
To know CT and US indication for acute cholecystitis
To know the pathological anatomy of gallbladder in CT and US
To recognize early sign of dangerous complication.
To recognize perforated gallbladder.
Background
Acute cholecystitis is a common cause of acute abdomen,
so it is critical to have a multimethodical radiological knowledge of the gallbladder and the bile duct.
It is also one of the most frequent reasons for hospitalization due to gastroenteric tract diseases.
Although nowadays the mortality related to this disease is greatly decreased,
complications may significantly worsen the prognosis.
Early diagnosis of these events is therefore necessary.
Findings and procedure details
The most dangerous complication of cholecystitis may show early findings both in CT than in US,
with possible evolutions in necrosis,
perforations,
abscess,
intraluminal haemorrhage and parietal emphysema.
In the suspicion of such complicances gallbladder wall should be carefully examined in search of gas,
abscess,
focal defects,
sloughed membranes,
and haemorrhage.
Another important complication is the gallbladder perforation.
Gallbladder perforation is a potentially life-threatening condition commonly seen as a complication of acute cholecystitis.
Urgent surgical intervention is often needed to reduce serious morbidity and mortality....
Conclusion
CT and US findings are essential for early assessment of cholecystitis dangerous complication.
In particular the CT protocol is the method of choice in complicated forms,
like perforation and it optimally examine the biliary system.
This is important mainly in fragile patients such as those with multiple pathologies,
like coagulophaty.
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