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Abdomen » Liver & Biliary System
Uncomplicated calculous acute cholecystitis
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Author(s) :
Vikas Arora, MD
 
Presentation A young woman presents with fever and pain in the right hypochondrium. An ultrasound was performed.
 
 
 
Caption: Sagittal scan of right upper quadrant
Description: The gall bladder is distended and shows the presence of calculi that produce posterior acoustic shadowing. Transducer compression over the gall bladder elicited pain. There is gall bladder wall thickening with fluid with both pericholecystic fluid and wall edema.
 
 
 
Caption: Transverse scan of right upper quadrant
Description: The thickened gall bladder wall with edema as well as pericholecystic fluid is demonstrated in this image.
 
 
 
Caption: Color Doppler of the thickened gallbladder wall
Description: The thickened gall bladder wall shows areas of increased vascularity- consistent with inflammation. The edema between the layers of the gall bladder wall and pericholecystic fluid is well seen.
 
Differential Diagnosis Uncomplicated calculous acute cholecystitis
 
Final Diagnosis Uncomplicated calculous acute cholecystitis
 
Discussion The ultrasound appearance of acute cholecystitis has been discussed in a previously published case. [Click here to view the case]
This case illustrates the classic ultrasound findings of acute cholecystitis – dilated, tender gall bladder, thickened walls, pericholecystic fluid and the presence of calculi.
 
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