acute cholecystitis
- 80-95% secondary to cystic duct obstruction by gallstone
- 5-6th decade; 75% female
ultrasound (sensitivity 85-95%; specificity 64-100%):
- GB wall thickening (>3mm)
- "halo sign" = GB wall lucency (in 70%)
- GB hydrops = AP diameter >5cm
- sonographic Murphy sign (85%)
- pericholecystic fluid
hepatobiliary scan (95% accuracy):
- nonvisualization of gallbladder
complications:
- gangrene
- irregular wall (ulcers, intraluminal hemmorhage, necrosis)
- hyperechoic foci within GB wall (microabscesses in
Rokitansky-Aschoff sinuses)
- perforation (5-10%): most commonly in fundus
- empyema: gravity dependent debris
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© 2002, C.E. Kahn, Jr.
2002-04-18