Difference between revisions of "Ultrasonography of cholecystitis"

From radlines.org
Jump to navigation Jump to search
(Started)
 
(Organized)
Line 8: Line 8:
  
 
==Findings==
 
==Findings==
Ultrasound findings suggestive of acute cholecystitis include gallstones, fluid surrounding the gallbladder, gallbladder wall thickening (wall thickness over 3&nbsp;mm),<ref name="van Breda VriesmanEngelbrecht2007">{{cite journal|last1=van Breda Vriesman|first1=Adriaan C.|last2=Engelbrecht|first2=Marc R.|last3=Smithuis|first3=Robin H. M.|last4=Puylaert|first4=Julien B. C. M.|title=Diffuse Gallbladder Wall Thickening: Differential Diagnosis|journal=American Journal of Roentgenology|volume=188|issue=2|year=2007|pages=495–501|issn=0361-803X|doi=10.2214/AJR.05.1712}}</ref> dilation of the bile duct, and a sonographic Murphy's sign.<ref name="Greenberger2012">Greenberger N.J., Paumgartner G (2012). Chapter 311. Diseases of the Gallbladder and Bile Ducts. In Longo D.L., Fauci A.S., Kasper D.L., Hauser S.L., Jameson J, Loscalzo J (Eds), Harrison's Principles of Internal Medicine, 18e</ref> A sonographic Murphy's sign which is where the patient experiences pain by pressure upon the gallbladder with the ultrasound probe in inspired state.<ref name="Urbano1">Urbano FL and Carroll M, Hospital Physician, November 2000: p51-52 (includes a description of the Murphy sign, and an ''erroneous'' description of the sonographic Murphy sign)</ref><ref name="Orient">Orient JM, Sapira's Art & Science of Bedside Diagnosis 3e, 2005, Lippincott Williams & Wilkins, p461 (describes one method in detail for eliciting the Murphy sign)</ref>
+
[[File:Ultrasonography of cholecystitis.jpg|thumb|Gallstones, wall thickening and pericholecystic fluid.]]
 
+
Ultrasound findings suggestive of acute cholecystitis include:<ref name="Greenberger2012">Greenberger N.J., Paumgartner G (2012). Chapter 311. Diseases of the Gallbladder and Bile Ducts. In Longo D.L., Fauci A.S., Kasper D.L., Hauser S.L., Jameson J, Loscalzo J (Eds), Harrison's Principles of Internal Medicine, 18e</ref>
<gallery>
+
*Gallstones
File:MildGBWallthickening(3.5mm)Mark.png|Mild gallbladder wall thickening of 3.5&nbsp;mm in a person with acute cholecystitis as seen on ultrasound
+
*Pericholecystic fluid
File:Pacutecholecystitits.png|Acute cholecystitis as seen on ultrasound. The closed arrow points to gallbladder wall thickening. Open arrow points to stones in the GB
+
*Gallbladder wall thickening (wall thickness over 3&nbsp;mm)<ref name="van Breda VriesmanEngelbrecht2007">{{cite journal|last1=van Breda Vriesman|first1=Adriaan C.|last2=Engelbrecht|first2=Marc R.|last3=Smithuis|first3=Robin H. M.|last4=Puylaert|first4=Julien B. C. M.|title=Diffuse Gallbladder Wall Thickening: Differential Diagnosis|journal=American Journal of Roentgenology|volume=188|issue=2|year=2007|pages=495–501|issn=0361-803X|doi=10.2214/AJR.05.1712}}</ref>  
</gallery>
+
*Dilation of the bile duct, and a sonographic Murphy's sign. A sonographic Murphy's sign which is where the patient experiences pain by pressure upon the gallbladder with the ultrasound probe in inspired state.<ref name="Urbano1">Urbano FL and Carroll M, Hospital Physician, November 2000: p51-52 (includes a description of the Murphy sign, and an ''erroneous'' description of the sonographic Murphy sign)</ref><ref name="Orient">Orient JM, Sapira's Art & Science of Bedside Diagnosis 3e, 2005, Lippincott Williams & Wilkins, p461 (describes one method in detail for eliciting the Murphy sign)</ref>
  
 
==References==
 
==References==
 
{{reflist}}
 
{{reflist}}

Revision as of 14:57, 1 July 2018

Author: Mikael Häggström [notes 1]

Planning

Choice of exam

Right upper quadrant abdominal ultrasound is most commonly used to diagnose cholecystitis.[1][2][3] Alternatively, CT scan may be used if complications such as perforation or gangrene are suspected.[4]

Findings

Gallstones, wall thickening and pericholecystic fluid.

Ultrasound findings suggestive of acute cholecystitis include:[5]

  • Gallstones
  • Pericholecystic fluid
  • Gallbladder wall thickening (wall thickness over 3 mm)[6]
  • Dilation of the bile duct, and a sonographic Murphy's sign. A sonographic Murphy's sign which is where the patient experiences pain by pressure upon the gallbladder with the ultrasound probe in inspired state.[7][8]

References

  1. Strasberg, SM (26 June 2008). "Clinical practice. Acute calculous cholecystitis. ". The New England Journal of Medicine 358 (26): 2804–11. doi:10.1056/nejmcp0800929. PMID 18579815. 
  2. "Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease ". Arch. Intern. Med. 154 (22): 2573–81. November 1994. doi:10.1001/archinte.154.22.2573. PMID 7979854. 
  3. "The sensitivity of hepatobiliary imaging and real-time ultrasonography in the detection of acute cholecystitis ". Arch Surg 120 (8): 904–6. August 1985. doi:10.1001/archsurg.1985.01390320028004. PMID 3893388. 
  4. Friedman L.S. (2015). Liver, Biliary Tract, & Pancreas Disorders. In Papadakis M.A., McPhee S.J., Rabow M.W. (Eds), Current Medical Diagnosis & Treatment 2015
  5. Greenberger N.J., Paumgartner G (2012). Chapter 311. Diseases of the Gallbladder and Bile Ducts. In Longo D.L., Fauci A.S., Kasper D.L., Hauser S.L., Jameson J, Loscalzo J (Eds), Harrison's Principles of Internal Medicine, 18e
  6. van Breda Vriesman, Adriaan C.; Engelbrecht, Marc R.; Smithuis, Robin H. M.; Puylaert, Julien B. C. M. (2007). "Diffuse Gallbladder Wall Thickening: Differential Diagnosis ". American Journal of Roentgenology 188 (2): 495–501. doi:10.2214/AJR.05.1712. ISSN 0361-803X. 
  7. Urbano FL and Carroll M, Hospital Physician, November 2000: p51-52 (includes a description of the Murphy sign, and an erroneous description of the sonographic Murphy sign)
  8. Orient JM, Sapira's Art & Science of Bedside Diagnosis 3e, 2005, Lippincott Williams & Wilkins, p461 (describes one method in detail for eliciting the Murphy sign)


Cite error: <ref> tags exist for a group named "notes", but no corresponding <references group="notes"/> tag was found, or a closing </ref> is missing