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Acute Cholecystitis and Biliary Obstruction
Paula Vergara-Wentland, MD; Paige Bennett, MD
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KEY FACTS

  • Imaging

    • Diagnostic Checklist

      TERMINOLOGY

      • Definitions

        • Acute cholecystitis: Absence of gallbladder filling in 1st hr of imaging
        • Common bile duct obstruction: Delayed biliary-to-bowel transit > 1st hr < 24 hrs (low grade) or > 24 hrs (high grade)

      IMAGING

      • General Features

        • Imaging Recommendations

          • Artifacts and Quality Control

            DIFFERENTIAL DIAGNOSIS

              PATHOLOGY

              • General Features

                • Staging, Grading, & Classification

                  CLINICAL ISSUES

                  • Natural History & Prognosis

                    • Treatment

                      DIAGNOSTIC CHECKLIST

                      • Image Interpretation Pearls

                        Selected References

                        1. ACR-SNMMI-SPR Practice Guideline for Hepatobiliary Scintigraphy 4.0. http://snmmi.files.cms-plus.com/docs/Hepatobiliary_Scintigraphy_V4.0b.pdf. Published August 23, 2010. Accessed July 10, 2014
                        2. Kaoutzanis C et al: Abdominal ultrasound versus hepato-imino diacetic acid scan in diagnosing acute cholecystitis--what is the real benefit? J Surg Res. 188(1):44-52, 2014
                        3. Freeman M et al: Choledocholithiasis: Clinical manifestations, diagnosis, and management. http://www.uptodate.com/contents/choledocholithiasis-clinical-manifestations-diagnosis-and-management. February 19, 2014. Accessed July 10, 2014
                        4. Lambie H et al: Tc99m-hepatobiliary iminodiacetic acid (HIDA) scintigraphy in clinical practice. Clin Radiol. 66(11):1094-105, 2011
                        5. Ziessman HA: Nuclear medicine hepatobiliary imaging. Clin Gastroenterol Hepatol. 8(2):111-6, 2010
                        6. Ziessman HA: Acute cholecystitis, biliary obstruction, and biliary leakage. Semin Nucl Med. 33(4):279-96, 2003
                        Related Anatomy
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                        Related Differential Diagnoses
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                        References
                        Tables

                        Tables

                        KEY FACTS

                        • Imaging

                          • Diagnostic Checklist

                            TERMINOLOGY

                            • Definitions

                              • Acute cholecystitis: Absence of gallbladder filling in 1st hr of imaging
                              • Common bile duct obstruction: Delayed biliary-to-bowel transit > 1st hr < 24 hrs (low grade) or > 24 hrs (high grade)

                            IMAGING

                            • General Features

                              • Imaging Recommendations

                                • Artifacts and Quality Control

                                  DIFFERENTIAL DIAGNOSIS

                                    PATHOLOGY

                                    • General Features

                                      • Staging, Grading, & Classification

                                        CLINICAL ISSUES

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. ACR-SNMMI-SPR Practice Guideline for Hepatobiliary Scintigraphy 4.0. http://snmmi.files.cms-plus.com/docs/Hepatobiliary_Scintigraphy_V4.0b.pdf. Published August 23, 2010. Accessed July 10, 2014
                                              2. Kaoutzanis C et al: Abdominal ultrasound versus hepato-imino diacetic acid scan in diagnosing acute cholecystitis--what is the real benefit? J Surg Res. 188(1):44-52, 2014
                                              3. Freeman M et al: Choledocholithiasis: Clinical manifestations, diagnosis, and management. http://www.uptodate.com/contents/choledocholithiasis-clinical-manifestations-diagnosis-and-management. February 19, 2014. Accessed July 10, 2014
                                              4. Lambie H et al: Tc99m-hepatobiliary iminodiacetic acid (HIDA) scintigraphy in clinical practice. Clin Radiol. 66(11):1094-105, 2011
                                              5. Ziessman HA: Nuclear medicine hepatobiliary imaging. Clin Gastroenterol Hepatol. 8(2):111-6, 2010
                                              6. Ziessman HA: Acute cholecystitis, biliary obstruction, and biliary leakage. Semin Nucl Med. 33(4):279-96, 2003