Acute cholecystitis (AC) is a common disease usually caused by gallstones. People with AC will often go to the emergency department to seek relief from severe upper abdominal pain and discomfort. While symptoms and laboratory results can indicate a hepatobiliary problem, medical imaging is necessary to confirm inflammation of the gallbladder. Ultrasound is the most commonly utilized modality for imaging the biliary system because it is highly sensitive for detecting stones and other biliary pathology. As with any ultrasound examination, it is crucial that the sonographer be fully competent. He or she must understand ultrasound physics, human anatomy, and the disease process of AC. This article will discuss the pathophysiology of each type of cholecystitis (acute calculous, gangrenous, emphysematous, acalculous, and chronic). It will also discuss the use of ultrasound and the role of the sonographer for diagnosing AC.
After reading this article, the participant should be able to:
- Describe signs and symptoms of AC.
- Identify the sonographic appearance of gallstones and acute calculous cholecystitis.
- Discuss the basic steps for diagnosing AC.
- Examine some of the scanning challenges faced by sonographers when evaluating for AC.