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Acute Calculous Cholecystitis
Maria A. Manning, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          • Scanning Tips

            TERMINOLOGY

            • Abbreviations

              • Acute cholecystitis
            • Definitions

              • Acute inflammation of gallbladder (GB) secondary to calculus or sludge obstructing cystic duct

            IMAGING

            • General Features

              • Ultrasonographic Findings

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Lopes Vendrami C et al: Gallbladder carcinoma and its differential diagnosis at MRI: what radiologists should know. Radiographics. 41(1):78-95, 2021
                                                2. de Santibañes M et al: Extended antibiotic therapy versus placebo after laparoscopic cholecystectomy for mild and moderate acute calculous cholecystitis: a randomized double-blind clinical trial. Surgery. Epub, 2018
                                                3. Loehfelm TW et al: The utility of hepatic artery velocity in diagnosing patients with acute cholecystitis. Abdom Radiol (NY). 43(5):1159-67, 2018
                                                4. Okamoto K et al: Tokyo Guidelines 2018: flowchart for the management of acute cholecystitis. J Hepatobiliary Pancreat Sci. 25(1):55-72, 2018
                                                5. Ratanaprasatporn L et al: Multimodality imaging, including dual-energy CT, in the evaluation of gallbladder disease. Radiographics. 38(1):75-89, 2018
                                                6. Gerstenmaier JF et al: Contrast-enhanced ultrasound in gallbladder disease: a pictorial review. Abdom Radiol (NY). 41(8):1640-52, 2016
                                                7. Ripollés T et al: Usefulness of contrast-enhanced US in the diagnosis of acute gangrenous cholecystitis: A comparative study with surgical and pathological findings. Eur J Radiol. 85(1):31-8, 2016
                                                8. Solomon RW et al: Morphine-modified hepatobiliary scanning protocol for the diagnosis of acute cholecystitis. AJR Am J Roentgenol. 207(4):865-70, 2016
                                                9. Kaoutzanis C et al: Is hepato-imino diacetic acid scan a better imaging modality than abdominal ultrasound for diagnosing acute cholecystitis? Am J Surg. 210(3):473-82, 2015
                                                10. Knab LM et al: Cholecystitis. Surg Clin North Am. 94(2):455-70, 2014
                                                11. Duncan CB et al: Evidence-based current surgical practice: calculous gallbladder disease. J Gastrointest Surg. 16(11):2011-25, 2012
                                                12. Kiewiet JJ et al: A systematic review and meta-analysis of diagnostic performance of imaging in acute cholecystitis. Radiology. 264(3):708-20, 2012
                                                13. Charalel RA et al: Complicated cholecystitis: the complementary roles of sonography and computed tomography. Ultrasound Q. 27(3):161-70, 2011
                                                14. Gore RM et al: Gallbladder imaging. Gastroenterol Clin North Am. 39(2):265-87, ix, 2010
                                                15. Smith EA et al: Cross-sectional imaging of acute and chronic gallbladder inflammatory disease. AJR Am J Roentgenol. 192(1):188-96, 2009
                                                16. Catalano OA et al: MR imaging of the gallbladder: a pictorial essay. Radiographics. 28(1):135-55; quiz 324, 2008
                                                17. Hanbidge AE et al: From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant. Radiographics. 24(4):1117-35, 2004
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        • Scanning Tips

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Acute cholecystitis
                                                          • Definitions

                                                            • Acute inflammation of gallbladder (GB) secondary to calculus or sludge obstructing cystic duct

                                                          IMAGING

                                                          • General Features

                                                            • Ultrasonographic Findings

                                                              • Radiographic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Nuclear Medicine Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Lopes Vendrami C et al: Gallbladder carcinoma and its differential diagnosis at MRI: what radiologists should know. Radiographics. 41(1):78-95, 2021
                                                                                              2. de Santibañes M et al: Extended antibiotic therapy versus placebo after laparoscopic cholecystectomy for mild and moderate acute calculous cholecystitis: a randomized double-blind clinical trial. Surgery. Epub, 2018
                                                                                              3. Loehfelm TW et al: The utility of hepatic artery velocity in diagnosing patients with acute cholecystitis. Abdom Radiol (NY). 43(5):1159-67, 2018
                                                                                              4. Okamoto K et al: Tokyo Guidelines 2018: flowchart for the management of acute cholecystitis. J Hepatobiliary Pancreat Sci. 25(1):55-72, 2018
                                                                                              5. Ratanaprasatporn L et al: Multimodality imaging, including dual-energy CT, in the evaluation of gallbladder disease. Radiographics. 38(1):75-89, 2018
                                                                                              6. Gerstenmaier JF et al: Contrast-enhanced ultrasound in gallbladder disease: a pictorial review. Abdom Radiol (NY). 41(8):1640-52, 2016
                                                                                              7. Ripollés T et al: Usefulness of contrast-enhanced US in the diagnosis of acute gangrenous cholecystitis: A comparative study with surgical and pathological findings. Eur J Radiol. 85(1):31-8, 2016
                                                                                              8. Solomon RW et al: Morphine-modified hepatobiliary scanning protocol for the diagnosis of acute cholecystitis. AJR Am J Roentgenol. 207(4):865-70, 2016
                                                                                              9. Kaoutzanis C et al: Is hepato-imino diacetic acid scan a better imaging modality than abdominal ultrasound for diagnosing acute cholecystitis? Am J Surg. 210(3):473-82, 2015
                                                                                              10. Knab LM et al: Cholecystitis. Surg Clin North Am. 94(2):455-70, 2014
                                                                                              11. Duncan CB et al: Evidence-based current surgical practice: calculous gallbladder disease. J Gastrointest Surg. 16(11):2011-25, 2012
                                                                                              12. Kiewiet JJ et al: A systematic review and meta-analysis of diagnostic performance of imaging in acute cholecystitis. Radiology. 264(3):708-20, 2012
                                                                                              13. Charalel RA et al: Complicated cholecystitis: the complementary roles of sonography and computed tomography. Ultrasound Q. 27(3):161-70, 2011
                                                                                              14. Gore RM et al: Gallbladder imaging. Gastroenterol Clin North Am. 39(2):265-87, ix, 2010
                                                                                              15. Smith EA et al: Cross-sectional imaging of acute and chronic gallbladder inflammatory disease. AJR Am J Roentgenol. 192(1):188-96, 2009
                                                                                              16. Catalano OA et al: MR imaging of the gallbladder: a pictorial essay. Radiographics. 28(1):135-55; quiz 324, 2008
                                                                                              17. Hanbidge AE et al: From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant. Radiographics. 24(4):1117-35, 2004