Ultrasonography of cholecystitis
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
Ultrasound findings suggestive of acute cholecystitis include gallstones, fluid surrounding the gallbladder, gallbladder wall thickening (wall thickness over 3 mm),[5] dilation of the bile duct, and a sonographic Murphy's sign.[6] 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]
- MildGBWallthickening(3.5mm)Mark.png
Mild gallbladder wall thickening of 3.5 mm in a person with acute cholecystitis as seen on ultrasound
- Pacutecholecystitits.png
Acute cholecystitis as seen on ultrasound. The closed arrow points to gallbladder wall thickening. Open arrow points to stones in the GB
References
- ↑ Strasberg, SM (26 June 2008). "Clinical practice. Acute calculous cholecystitis. ". The New England Journal of Medicine 358 (26): 2804–11. doi:. PMID 18579815.
- ↑ "Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease ". Arch. Intern. Med. 154 (22): 2573–81. November 1994. doi:. PMID 7979854.
- ↑ "The sensitivity of hepatobiliary imaging and real-time ultrasonography in the detection of acute cholecystitis ". Arch Surg 120 (8): 904–6. August 1985. doi:. PMID 3893388.
- ↑ 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
- ↑ 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:. ISSN 0361-803X.
- ↑ 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
- ↑ 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)
- ↑ 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
