The diagnosis of acute acalculous cholecystitis: a comparison of sonography, scintigraphy, and CT

Mirvis, Stuart E.; Vainright, J R; Nelson, A.; Johnston, G. S.; Shorr, Robert M.; Rodríguez, Aurelio; Whitley, Nancy O.

doi:10.2214/ajr.147.6.1171

Cited by 215 publications

(113 citation statements)

References 31 publications

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“…However, the diagnosis of acute cholecystitis can be made using CT. The CT findings associated with acute cholecystitis include gallbladder wall thickening, indistinctness of the interface between the gallbladder and the liver, gallbladder distension, pericholecystic stranding, subserosal edema, pericholecystic fluid, high-attenuation bile, and the presence of luminal or mural gas [1][2][3][4][5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…However, some patients with acute cholecystitis have symptoms suggestive of an abscess or other intraabdominal inflammation and so may be referred for an abdominal CT. CT findings of acute cholecystitis have been described [1][2][3][4][5][6][7][8]. Some of these descriptions, however, have been restricted to subtypes of acute cholecystitis such as acalculous cholecystitis or to the complications of cholecystitis.…”

Section: Ajr I996;i66:i085-i 088mentioning

confidence: 99%

“…The purposes of this paper are to review the CT appearance of acute cholecystitis, to apply previously proposed criteria for diagnosing acute cholecystitis, and to determine the usefulness of CT in diagnosing acute cholecystitis in our selected patient population. In a previous publication [1], CT criteria for the diagnosis of acute acalculous cholecystitis were proposed. Major criteria consisted of gallbladder wall thickening, pericholecystic fluid, subserosal edema, intramural gas, and sloughed mucosa.…”

Section: Ajr I996;i66:i085-i 088mentioning

confidence: 99%

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CT evaluation of acute cholecystitis: findings and usefulness in diagnosis.

Fidler

Paulson

Layfield

1996

American Journal of Roentgenology

129

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Section: Discussionmentioning

confidence: 99%

Section: Ajr I996;i66:i085-i 088mentioning

confidence: 99%

Section: Ajr I996;i66:i085-i 088mentioning

confidence: 99%

See 1 more Smart Citation

CT evaluation of acute cholecystitis: findings and usefulness in diagnosis.

Fidler

Paulson

Layfield

1996

American Journal of Roentgenology

129

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“…Usually patients present with fever, jaundice, RUQ or epigastric pain which is less localized in younger children, nausea and vomiting. Ultrasonography is the main diagnostic modality of AAC (19,13). Ultrasonographic findings in AAC include gallbladder wall thickening of at least 3.5mm, globular distention of the gallbladder, sludge, pericholecystic fluid and striated gallbladder wall.…”

Section: Discussionmentioning

confidence: 99%

Acute Acalculous Cholecystitis Complicating the Course of Infectious Mononucleosis

2015

IJSR

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Infectious Mononucleosis is the most common medical condition caused by Epstein-Barr virus (EBV). EBV is a member of the family Herpesviridae widely prevalent in nature and infects >95% of the world's population. EBV establishes lifelong latent infection after the primary illnes, memory B cells are the reservoir for EBV in the body. Fatigue, fever, pharyngitis, lymphadenopathy and splenomegaly are the mayor clinical manifestations of Infectious Mononucleosis. Hepatic inflammation probably due to infiltration of cytotoxic T lymphocytes with mild, transient elevations in serum aminotransferases is often reported and mild jaundice is found in 5% of cases. Acute acalculous cholecystitis is the inflammation of gallbladder without the presence of calculi. This is uncommon in children and is usually caused by infections and rarely follow abdominal trauma, burn injury or associate systemic vasculitis. AAC complicating the course of Infectious Mononucleosis is rarely reported in children but is associated with favorable outcome, all cases recovered with medical treatment. We report the case of a 8 years female patient with AAC during the course of IM and review of the literature.

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“…Hydrops and sludge are minor criteria. The triad composed by thickness, hydrops, and sludge is the one preferred for diagnosis [34][35][36][37][38][39].…”

Section: Role Of Ultrasonographymentioning

confidence: 99%

Acute acalculous cholecystitis and cardiovascular disease: a land of confusion

Tana

Cocco

et al. 2015

J Ultrasound

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Acute acalculous cholecystitis (AAC) can be defined as acute inflammatory disease of the gallbladder without evidence of gallstones. The first case was reported in 1844 by Duncan et al.; however, some cases may have been missed previously in view of the complexity of the diagnosis. Several risk factors have been identified, and cardiovascular disease (CVD), in view of its multiple mechanisms of action, seems to play a key role. Atypical clinical onset, paucity of symptoms, overlap with comorbidities, and lack of robust, controlled trials result often in under or misdiagnosed cases. Moreover, laboratory results may be negative or not specific in the late stage of the disease, when a surgical treatment cannot be longer helpful if complications arise. A rapid diagnosis is therefore essential to achieve a prompt treatment and to avoid further clinical deterioration. In this short review, we would present the current evidence regarding epidemiology, pathophysiology, and clinical presentation of the complex relation between AAC and CVD. Then, we fully emphasize the role of ultrasound to achieve an early diagnosis and an appropriate treatment in suspected cases, reducing mortality and complications rates.Keywords Acute acalculous cholecystitis Á Gallbladder Á Cardiovascular disease Á Ultrasonography Á Emergency Department Á Surgery Riassunto La colecistite acuta alitiasica (AAC) può essere definita come una infiammazione acuta della colecisti in assenza di calcoli. Uno dei primi casi clinici riportati in letteratura risale al 1844 (Duncan et al.) ma verosimilmente alcuni di questi sono passati inosservati a causa della complessitá del percorso diagnostico. Numerosi fattori di rischio sono stati identificati e, tra questi, le malattie cardiovascolari, in considerazione di diversi meccanismi d'azione, sembrano assumere una posizione importante e giocare un ruolo chiave. Molti casi possono passare inosservati per varie ragioni che vanno dall'esordio clinico atipico, la povertá di sintomi, la sovrapposizione clinica e strumentale con altre comorbiditá, la carenza di trial controllati. Inoltre i test di laboratorio possono risultare negativi o non specifici anche negli stadi avanzati della malattia, quando la terapia chirurgica può non rivelarsi più utile in caso di complicanze. Una diagnosi rapida é dunque necessaria per instaurare un trattamento mirato e per evitare un ulteriore deterioramento clinico. In questa breve revisione vogliamo mettere in risalto le evidenze attuali che riguardano l'epidemiologia, la fisiopatologia e la presentazione clinica della complessa relazione esistente tra le malattie cardiovascolari e la colecistite acuta alitiasica. Il nostro intento é dunque quello di enfatizzare il ruolo dell'ultrasonografia nel raggiungimento, nei casi sospetti, di una diagnosi precoce e di un trattamento appropriato, al fine di ridurre il tasso di complicanze e la mortalitá.

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The diagnosis of acute acalculous cholecystitis: a comparison of sonography, scintigraphy, and CT

Cited by 215 publications

References 31 publications

CT evaluation of acute cholecystitis: findings and usefulness in diagnosis.

CT evaluation of acute cholecystitis: findings and usefulness in diagnosis.

Acute Acalculous Cholecystitis Complicating the Course of Infectious Mononucleosis

Acute acalculous cholecystitis and cardiovascular disease: a land of confusion

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