Imaging of acute cholecystitis and cholecystitis-associated complications in the emergency setting.

Acute cholecystitis is a common cause of right upper quadrant pain in patients presenting at the emergency department. Early diagnosis and recognition of associated complications, though challenging, are essential for timely management. Imaging studies, including ultrasonography, computed tomography and magnetic resonance imaging, are increasingly utilised for the evaluation of suspected cases of cholecystitis. These investigations help in diagnosis, identification of complications and surgical planning. Imaging features of acute cholecystitis have been described in the literature and are variable, depending on the stage of inflammation. This article discusses the spectrum of cholecystitis-associated complications and their imaging manifestations. We also suggest a checklist for the prompt and accurate identification of complications in acute cholecystitis.

[1]  A. Reginelli,et al.  Accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis: review of the literature , 2013, Critical Ultrasound Journal.

[2]  A. Nagar,et al.  Emphysematous cholecystitis: Imaging findings in nine patients , 2011, Indian Journal of Radiology and Imaging.

[3]  M. Safioleas,et al.  Mirizzi Syndrome: an unexpected problem of cholelithiasis. Our experience with 27 cases , 2008, International seminars in surgical oncology : ISSO.

[4]  R. Chaudhary,et al.  The CT appearances of gallbladder perforation. , 2007, The British journal of radiology.

[5]  M. Engelbrecht,et al.  Diffuse gallbladder wall thickening: differential diagnosis. , 2007, AJR. American journal of roentgenology.

[6]  Masahiro Yoshida,et al.  Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines , 2007, Journal of hepato-biliary-pancreatic surgery.

[7]  Y. Masannat,et al.  Gallstone ileus: a review. , 2006, The Mount Sinai journal of medicine, New York.

[8]  A. Osadchy,et al.  Extrarenal manifestations of severe acute pyelonephritis: CT findings in 21 cases , 2006, Emergency Radiology.

[9]  R. Grassi,et al.  Role of helical CT in diagnosis of gallstone ileus and related conditions. , 2005, AJR. American journal of roentgenology.

[10]  S. Fagan,et al.  Prognostic factors for the development of gangrenous cholecystitis. , 2003, American journal of surgery.

[11]  P. Pickhardt,et al.  CT, MR Cholangiopancreatography, and Endoscopy Findings in Bouveret's Syndrome , 2003 .

[12]  P. Pickhardt,et al.  Case report. CT, MR cholangiopancreatography, and endoscopy findings in Bouveret's syndrome. , 2003, AJR. American journal of roentgenology.

[13]  I. Beckingham,et al.  Acute cholecystitis , 2002, BMJ : British Medical Journal.

[14]  Henry Rusinek,et al.  CT findings in acute gangrenous cholecystitis. , 2002, AJR. American journal of roentgenology.

[15]  E. Paulson,et al.  Acute cholecystitis: CT findings. , 2000, Seminars in ultrasound, CT, and MR.

[16]  H. Yoo,et al.  Radiologic findings of Mirizzi syndrome with emphasis on MRI. , 2000, Yonsei medical journal.

[17]  E. Paulson,et al.  CT evaluation of acute cholecystitis: findings and usefulness in diagnosis. , 1996, AJR. American journal of roentgenology.

[18]  K. Yamashita,et al.  CT finding of transient focal increased attenuation of the liver adjacent to the gallbladder in acute cholecystitis. , 1995, AJR. American journal of roentgenology.

[19]  P. Colletti,et al.  Cholelithiasis: evaluation with CT. , 1987, Radiology.

[20]  P. Colletti,et al.  Real-time sonography in suspected acute cholecystitis. Prospective evaluation of primary and secondary signs. , 1985, Radiology.

[21]  L. Berland,et al.  CT appearance of Mirizzi syndrome. , 1984, Journal of computer assisted tomography.

[22]  K. LeBlanc,et al.  Spontaneous Biliary Enteric Fistulas , 1983, Southern medical journal.

[23]  N. Thomford,et al.  Biliary intestinal fistula. , 1970, American journal of surgery.

[24]  R. Berger,et al.  The pathogenesis of acute cholecystitis. , 1960, Archives of surgery.

[25]  L. Rigler,et al.  GALLSTONE OBSTRUCTION: PATHOGENESIS AND ROENTGEN MANIFESTATIONS , 1941 .