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Overview of Acute Cholecystitis
R. Brooke Jeffrey, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Acute calculous cholecystitis, acute acalculous cholecystitis
          • Definitions

            • Acute inflammation of gallbladder (GB)

          IMAGING

          • General Features

            • Fluoroscopic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic 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. Gupta RT: Evaluation of the biliary tree and gallbladder with hepatocellular MR contrast agents. Curr Probl Diagn Radiol. 42(2):67-76, 2013
                                              2. Teefey SA et al: Acute cholecystitis: do sonographic findings and WBC count predict gangrenous changes? AJR Am J Roentgenol. 200(2):363-9, 2013
                                              3. Tong Z et al: Acute cholecystitis in the late phase of severe acute pancreatitis: a neglected problem. Pancreas. 42(3):531-6, 2013
                                              4. Elsayes KM et al: Gastrointestinal manifestations of diabetes mellitus: spectrum of imaging findings. J Comput Assist Tomogr. 33(1):86-9, 2009
                                              5. Kim HO et al: Impact of delayed laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage for patients with complicated acute cholecystitis. Surg Laparosc Endosc Percutan Tech. 19(1):20-4, 2009
                                              6. Smith EA et al: Cross-sectional imaging of acute and chronic gallbladder inflammatory disease. AJR Am J Roentgenol. 192(1):188-96, 2009
                                              7. Walton TJ et al: Imaging after medically managed severe acute cholecystitis. Gut. 58(3):421, 472, 2009
                                              8. Ha JP et al: Cholecystectomy or not after percutaneous cholecystostomy for acute calculous cholecystitis in high-risk patients. Hepatogastroenterology. 55(86-87):1497-502, 2008
                                              9. Barie PS et al: Acute acalculous cholecystitis. Curr Gastroenterol Rep. 5(4):302-9, 2003
                                              10. Bennett GL et al: Ultrasound and CT evaluation of emergent gallbladder pathology. Radiol Clin North Am. 41(6):1203-16, 2003
                                              11. Browning JD et al: Gallstone disease and its complications. Semin Gastrointest Dis. 14(4):165-77, 2003
                                              12. Cheema S et al: Timing of laparoscopic cholecystectomy in acute cholecystitis. Ir J Med Sci. 172(3):128-31, 2003
                                              13. Fayad LM et al: Functional magnetic resonance cholangiography (fMRC) of the gallbladder and biliary tree with contrast-enhanced magnetic resonance cholangiography. J Magn Reson Imaging. 18(4):449-60, 2003
                                              14. Gandolfi L et al: The role of ultrasound in biliary and pancreatic diseases. Eur J Ultrasound. 16(3):141-59, 2003
                                              15. Ko CW et al: Gastrointestinal disorders of the critically ill. Biliary sludge and cholecystitis. Best Pract Res Clin Gastroenterol. 17(3):383-96, 2003
                                              16. Oh KY et al: Limited abdominal MRI in the evaluation of acute right upper quadrant pain. Abdom Imaging. 28(5):643-51, 2003
                                              17. Ozaras R et al: Acute viral cholecystitis due to hepatitis A virus infection. J Clin Gastroenterol. 37(1):79-81, 2003
                                              18. Pazzi P et al: Biliary sludge: the sluggish gallbladder. Dig Liver Dis. 35 Suppl 3:S39-45, 2003
                                              19. Pedrosa I et al: The interrupted rim sign in acute cholecystitis: a method to identify the gangrenous form with MRI. J Magn Reson Imaging. 18(3):360-3, 2003
                                              20. Roth T et al: Acute acalculous cholecystitis associated with aortic dissection: report of a case. Surg Today. 33(8):633-5, 2003
                                              21. Trowbridge RL et al: Does this patient have acute cholecystitis? JAMA. 289(1):80-6, 2003
                                              22. Yusoff IF et al: Diagnosis and management of cholecystitis and cholangitis. Gastroenterol Clin North Am. 32(4):1145-68, 2003
                                              23. Abou-Saif A et al: Complications of gallstone disease: Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. Am J Gastroenterol. 97(2):249-54, 2002
                                              24. Adusumilli S et al: MR imaging of the gallbladder. Magn Reson Imaging Clin N Am. 10(1):165-84, 2002
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Acute calculous cholecystitis, acute acalculous cholecystitis
                                                      • Definitions

                                                        • Acute inflammation of gallbladder (GB)

                                                      IMAGING

                                                      • General Features

                                                        • Fluoroscopic Findings

                                                          • CT Findings

                                                            • MR Findings

                                                              • Ultrasonographic 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. Gupta RT: Evaluation of the biliary tree and gallbladder with hepatocellular MR contrast agents. Curr Probl Diagn Radiol. 42(2):67-76, 2013
                                                                                          2. Teefey SA et al: Acute cholecystitis: do sonographic findings and WBC count predict gangrenous changes? AJR Am J Roentgenol. 200(2):363-9, 2013
                                                                                          3. Tong Z et al: Acute cholecystitis in the late phase of severe acute pancreatitis: a neglected problem. Pancreas. 42(3):531-6, 2013
                                                                                          4. Elsayes KM et al: Gastrointestinal manifestations of diabetes mellitus: spectrum of imaging findings. J Comput Assist Tomogr. 33(1):86-9, 2009
                                                                                          5. Kim HO et al: Impact of delayed laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage for patients with complicated acute cholecystitis. Surg Laparosc Endosc Percutan Tech. 19(1):20-4, 2009
                                                                                          6. Smith EA et al: Cross-sectional imaging of acute and chronic gallbladder inflammatory disease. AJR Am J Roentgenol. 192(1):188-96, 2009
                                                                                          7. Walton TJ et al: Imaging after medically managed severe acute cholecystitis. Gut. 58(3):421, 472, 2009
                                                                                          8. Ha JP et al: Cholecystectomy or not after percutaneous cholecystostomy for acute calculous cholecystitis in high-risk patients. Hepatogastroenterology. 55(86-87):1497-502, 2008
                                                                                          9. Barie PS et al: Acute acalculous cholecystitis. Curr Gastroenterol Rep. 5(4):302-9, 2003
                                                                                          10. Bennett GL et al: Ultrasound and CT evaluation of emergent gallbladder pathology. Radiol Clin North Am. 41(6):1203-16, 2003
                                                                                          11. Browning JD et al: Gallstone disease and its complications. Semin Gastrointest Dis. 14(4):165-77, 2003
                                                                                          12. Cheema S et al: Timing of laparoscopic cholecystectomy in acute cholecystitis. Ir J Med Sci. 172(3):128-31, 2003
                                                                                          13. Fayad LM et al: Functional magnetic resonance cholangiography (fMRC) of the gallbladder and biliary tree with contrast-enhanced magnetic resonance cholangiography. J Magn Reson Imaging. 18(4):449-60, 2003
                                                                                          14. Gandolfi L et al: The role of ultrasound in biliary and pancreatic diseases. Eur J Ultrasound. 16(3):141-59, 2003
                                                                                          15. Ko CW et al: Gastrointestinal disorders of the critically ill. Biliary sludge and cholecystitis. Best Pract Res Clin Gastroenterol. 17(3):383-96, 2003
                                                                                          16. Oh KY et al: Limited abdominal MRI in the evaluation of acute right upper quadrant pain. Abdom Imaging. 28(5):643-51, 2003
                                                                                          17. Ozaras R et al: Acute viral cholecystitis due to hepatitis A virus infection. J Clin Gastroenterol. 37(1):79-81, 2003
                                                                                          18. Pazzi P et al: Biliary sludge: the sluggish gallbladder. Dig Liver Dis. 35 Suppl 3:S39-45, 2003
                                                                                          19. Pedrosa I et al: The interrupted rim sign in acute cholecystitis: a method to identify the gangrenous form with MRI. J Magn Reson Imaging. 18(3):360-3, 2003
                                                                                          20. Roth T et al: Acute acalculous cholecystitis associated with aortic dissection: report of a case. Surg Today. 33(8):633-5, 2003
                                                                                          21. Trowbridge RL et al: Does this patient have acute cholecystitis? JAMA. 289(1):80-6, 2003
                                                                                          22. Yusoff IF et al: Diagnosis and management of cholecystitis and cholangitis. Gastroenterol Clin North Am. 32(4):1145-68, 2003
                                                                                          23. Abou-Saif A et al: Complications of gallstone disease: Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. Am J Gastroenterol. 97(2):249-54, 2002
                                                                                          24. Adusumilli S et al: MR imaging of the gallbladder. Magn Reson Imaging Clin N Am. 10(1):165-84, 2002