BACKGROUND Acute cholecystitis is an acute inflammatory condition of the gall bladder. Cross-sectional imaging is critical in identifying the complications associated with acute cholecystitis. While ultrasound is still the first investigation for patients suspected of cholecystitis, acute cholecystitis and complications that emerge of it are better appreciated by CT. The sensitivity with which it can be evaluated is better with C.T. METHODS This is a prospective observational study done on 50 patients, on whom CT was performed, over a period of 14 months between March 2016 and May 2017. RESULTS 50 patients with symptoms related to acute cholecystitis were evaluated by CT. The average age of the group was 60.7 ± 1.76 (range 31-80) with a sex distribution in the group being 21:29 (M: F). Right upper quadrant pain was the most common presenting complaint in 84.0% of cases. Fever (36.0%), nausea (32%), vomiting (30.0%), dyspepsia (28.0%), jaundice (22.0%), vague abdominal discomfort (16.0%), right upper quadrant mass (16.0%), and abdominal distension (2.0%) were the other presenting complaints. 42 of them (84.0%) had calculi, 33 (66.0%) patients show wall thickness of more than 4 mm and 32 (64.0%) cases showed grossly distended GB. Pericholecystic fluid/oedema was seen in 32 (64.0%) cases and 42 (84.0%) cases show the presence of pericholecystic fat stranding. 21 cases (42.0%) showed enhancement of the adjacent liver parenchyma. CONCLUSIONS CT is a reliable imaging modality for diagnosing of acute cholecystitis and its associated complications in emergency department. Cholelithiasis, gall bladder wall thickening, gall bladder distension, pericholecystic fluid/oedema, pericholecystic fat stranding, transient increased enhancement of adjacent liver parenchyma are often associated with acute cholecystitis and these findings can be well established from CT. CT is also useful for evaluating the many complications of acute cholecystitis, such as emphysematous cholecystitis, gangrenous cholecystitis, haemorrhage, and gall stone ileus.

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