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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: Gallbladder (GB) inflammation, right upper quadrant pain, leukocytosis, fever due to cystic duct obstruction 
          • Most commonly caused by gallstones (acute calculous cholecystitis or ACC)
          • 5-10% of cases are acute acalculous cholecystitis (AAC), inflammation not caused by gallstones
        • Biliary obstruction 
          • Obstruction of common bile duct due to stones, tumor, stricture (iatrogenic), choledochal cysts

      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. Ardekani AE et al: False-positive elevated CEA during colon cancer surveillance: a cholecystitis case report diagnosed by PET-CT scan. J Surg Case Rep. 2019(6):rjz138, 2019
                        2. Mhamdi S et al: Emphysematous cholecystitis. N Engl J Med. 381(8):e14, 2019
                        3. 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
                        4. 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
                        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: Gallbladder (GB) inflammation, right upper quadrant pain, leukocytosis, fever due to cystic duct obstruction 
                                • Most commonly caused by gallstones (acute calculous cholecystitis or ACC)
                                • 5-10% of cases are acute acalculous cholecystitis (AAC), inflammation not caused by gallstones
                              • Biliary obstruction 
                                • Obstruction of common bile duct due to stones, tumor, stricture (iatrogenic), choledochal cysts

                            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. Ardekani AE et al: False-positive elevated CEA during colon cancer surveillance: a cholecystitis case report diagnosed by PET-CT scan. J Surg Case Rep. 2019(6):rjz138, 2019
                                              2. Mhamdi S et al: Emphysematous cholecystitis. N Engl J Med. 381(8):e14, 2019
                                              3. 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
                                              4. 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