Ultrasound in postoperative acalculous cholecystitis

Becker, Christoph; Burckhardt, Beat; Terrier, François

doi:10.1007/bf02035031

Cited by 29 publications

(9 citation statements)

References 13 publications

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“…but increases the specificity to above 95%. In line with most authors [3,19] we classified the three major criteria--thickening of the gallbladder wall >3.5 mm, hydrops, and sludge--as pathognomomc sonographic signs for acute acalculous cholecystitis, and as a result these changes of the gallbladder were found to be the most frequent findings in our series. Concerning the therapeutic management of posttraumatic or postoperative acute acalculous cholecystitis, cholecystectomy has to be the golden standard of clinical relevance.…”

Section: Discussionsupporting

confidence: 59%

Acute acalculous cholecystitis in severely traumatized patients: a prospective sonographic study

et al. 1992

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Acute acalculous cholecystitis is a well known complication in severely traumatized patients. Existing data originate from retrospective analyses and episodic case reports. In a prospective ultrasonographic study 25 polytraumatized patients admitted to our intensive care unit between January 1, 1989, and December 31, 1989, were examined in daily intervals for this condition. Trauma scoring was performed according to the injury severity score (ISS) and polytrauma score (PTS). "Stress cholecystitis" was defined as a combination of hydrops of the gallbladder, an increased mural thickness (> 3.5 mm), and the demonstration of "sludge." We were able to demonstrate this diagnostic triad in four out of 25 patients (= 16%). As a consequence early elective cholecystectomy was done in one patient. The remaining patients were treated conservatively. The incidence of stress cholecystitis in severely traumatized patients is probably higher than figures so far published suggest. Ultrasonography is a reliable method of early detection and follow-up for this complication.

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Section: Discussionsupporting

confidence: 59%

Acute acalculous cholecystitis in severely traumatized patients: a prospective sonographic study

et al. 1992

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“…1 Isolated reports have suggested that serial sonograms might be of value in equivocal cases of AAC. 6 In a review of 11 patients with proved postoperative AAC, Becker and coworkers reported a patient who demonstrated progressive gallbladder wall thickening (5 mm to 8 mm) within a 3 day span. 6 In a prior report we retrospectively J Ultrasound Med 4:183-187, 1993 reviewed the CT and sonographic findings in 17 patients with AAC over a 6 year period from 1984 to 1989.…”

Section: Discussionmentioning

confidence: 99%

“…6 In a review of 11 patients with proved postoperative AAC, Becker and coworkers reported a patient who demonstrated progressive gallbladder wall thickening (5 mm to 8 mm) within a 3 day span. 6 In a prior report we retrospectively J Ultrasound Med 4:183-187, 1993 reviewed the CT and sonographic findings in 17 patients with AAC over a 6 year period from 1984 to 1989. 5 Of the 13 patients undergoing sonography, three had normal gallbladder wall thickness.…”

Section: Discussionmentioning

confidence: 99%

Follow-up sonography in suspected acalculous cholecystitis: preliminary clinical experience

Jeffrey

Sommer

1993

Journal of Ultrasound in Medicine

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Fourteen adult patients with clinically suspected AAC and inconclusive initial sonograms underwent follow‐up sonography within 24 hours. Eight patients had initial studies demonstrating a normal thickness of the gallbladder wall. Four of these patients demonstrated progressive thickening of the gallbladder wall on follow‐up scans and were diagnosed as having AAC. In three of these patients AAC was proved at surgery, and the remaining patient improved clinically after percutaneous cholecystostomy. Four other patients with normal gallbladder wall thickness on both the initial and follow‐up sonograms had benign clinical follow‐up results without evidence of AAC. The remaining six patients had a thickened gallbladder on the initial sonogram. In one of these patients, the gallbladder wall thickening resolved on follow‐up sonography. In the remaining five patients the gallbladder wall thickening did not change. Four of these patients had benign follow‐up results but one patient was found to have AAC at surgery. Follow‐up sonography may be helpful to confirm AAC if there is progressive edema of the gallbladder wall. A normal gallbladder wall on an initial study does not exclude early AAC. Thickening of the gallbladder wall on initial studies still remains a problem and other ancillary criteria must be used to establish the diagnosis of AAC.

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“…To-date, US is often the initial imaging modality in critically ill patients who are suspected of having AC (1,(5)(6)(7)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)28). Despite the great variation in sensitivity and specificity for US diagnosis of AC (1, 5-7, 10-13, 16, 17, 19, 21-23, 26, 28), other imaging modalities are either not available in the ICU or do not perform superiorly to US (2,6,16,23,25).…”

Section: Resultsmentioning

confidence: 99%

“…In addition, follow-up sonography may be helpful in confirming the diagnosis (1,10). Aspiration from the GB has a limited role in establishing the diagnosis of AC (15).…”

mentioning

confidence: 99%