Diagnosis of Acute Cholecystitis: Sensitivity of Sonography, Cholescintigraphy, and Combined Sonography-Cholescintigraphy

Acalculous Cholecystitis or Biliary Dyskinesia for Epstein-Barr Virus Gallbladder Involvement?

“…In the second patient the delay of gallbladder emptying was suggestive of mild biliary dyskinesia whereas its filling was normal, putting therefore in doubt the diagnosis of acute cholecystitis given that sensitivity of non visualization of gallbladder in cases of cholecystitis is estimated to be high (Kalimi et al, 2001).…”

“…The ejection fraction in the initial study of the first patient was zero indicating that there was substantial biliary dyskinesia, as a normal gallbladder ejection fraction has been defined as greater than 35% (Middleton and Williams, 2001). More importantly, the gallbladder was fulfilled, while it has been recognized that in cases of acute cholecystitis the filling is abolished due to the cystic duct obstruction from an entrapped stone or from a deteriorating inflammatory process (Kalimi et al, 2001).…”

Sonographic Evaluation of Effect of Smoking and Fatty Meals on Gallbladder

“…They concluded that refilling is delayed in chronic smoker and in acute process, smoking might cause gallbladder smooth muscle contraction. 5 Gallbladder imaging with provocative testing with cholecystokinin or fatty meals has been tried with oral cholecystography 6,7 , dynamic ultrasound and HIDA scintigraphy [8][9][10][11][12][13][14][15] . We use 3D ultrasound for estimation of gallbladder volume.…”

Is hepato-imino diacetic acid scan a better imaging modality than abdominal ultrasound for diagnosing acute cholecystitis?

“…11 Prior studies have suggested the diagnostic accuracy of AUS to be inferior to that of HIDA scan in predicting acute cholecystitis, but all available studies had small numbers of subjects. [12][13][14] To date, the majority of physicians continue to use AUS as the initial imaging modality when suspecting acute cholecystitis. 12,15 We previously described a lower sensitivity of AUS when compared with HIDA scan for the diagnosis of acute cholecystitis.…”