Abstract
BackgroundTo evaluate the accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis in comparison with other imaging modalities.MethodsThe authors performed a search of the Medline/ PubMed (National Library of Medicine, Bethesda, Maryland) for original research and review publications examining the accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis. The search design utilized a single or combination of the following terms : (1) acute cholecystitis, (2) ultrasonography, (3) computed tomography, (4) magnetic resonance cholangiopancreatography and (5) cholescintigraphy. This review was restricted to human studies and to English-language literature. Four authors reviewed all the titles and subsequent the abstract of 198 articles that appeared appropriate. Other articles were recognized by reviewing the reference lists of significant papers. Finally, the full text of 31 papers was reviewed.ResultsSonography is still used as the initial imaging technique for evaluating patients with suspected acute calculous cholecystitis because of its high sensitivity at the detection of GB stones, its real-time character, and its speed and portability. Cholescintigraphy still has the highest sensitivity and specificity in patients who are suspected of having acute cholecystitis. However, due to a combination of reasons including logistic drawbacks, broad imaging capability and clinician referral pattern the use of cholescintigraphy is limited in clinical practice. CT is particularly useful for evaluating the many complications of acute calculous cholecystitis. The lack of widespread availability of MRI and the relatively high cost prohibits its primary use in patients with acute calculous cholecystitis.ConclusionsUS is currently considered the preferred initial imaging technique for patients who are clinically suspected of having acute calculous cholecystitis.
Highlights
To evaluate the accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis in comparison with other imaging modalities
In this paper we evaluate the accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis in comparison with other imaging modalities through a literature search
Acute calculous cholecystitis: diagnosis with ultrasonography Ultrasound (US) is the preferred imaging examination for the diagnosis of acute cholecystitis and is the first method used when the clinical presentation is suggestive of biliary pathology
Summary
To evaluate the accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis in comparison with other imaging modalities. Acute cholecystitis is defined as an acute inflammation of the gallbladder wall, regardless of the cause. In the many of cases, the underlying etiology is the obstruction of the cystic duct due to an impacted stone in either the neck of the gallbladder or the cystic duct (acute calculous cholecystitis). Acute cholecystitis can develop without associated cholelithiasis (acute acalculous cholecystitis). It is very uncommon that a patient without an history of biliary symptoms, such as colic pain, develop an acute cholecystitis. In 80% of cases, the cholelithiasis is primarily composed of cholesterol, with pigments, calcium bilirubinate, and calcium carbonate accounting for most of the remainder [2,3]
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