Acute cholecystitis in the elderly: use of computed tomography and correlation with ultrasonography

Abstract

Background Elderly patients diagnosed with acute cholecystitis (AC) may undergo both ultrasonography (US) and computed tomography (CT). Methods A total of 475 patients (age, >64 y) with AC were included. Results Groups included US alone (n = 240), CT alone (n = 60), and CT + US (n = 168). Sixty patients (35.7%) in the US + CT group had inflammation in both studies, 34 (20.2%) had inflammation only on US, and 32 (19.0%) had inflammation only on CT. In the US + CT group, detection of cholelithiasis was not different, but mean common bile duct size did not correlate. There was no difference among the groups in age, sex, medical service admission, nonambulatory status, dementia, diabetes, or coronary artery disease. Peritonitis, leukocytosis, and acidosis were more frequent in the 2 groups undergoing CT. The cholecystectomy rate was lowest (and the complication rate was highest) in the CT + US group. Conclusions CT often is used in the diagnosis of AC in the elderly, especially those with more acute presentations. CT and US findings may be complementary in AC.