Chronic cholecystitis CT: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
 
(5 intermediate revisions by one other user not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{CMG}}; {{AE}} {{ADI}}, {{MMF}}
{{CMG}}; {{AE}} {{ADI}}, {{MMF}}
{{Cholecystitis}}
{{Cholecystitis}}


==Overview==
==Overview==
The reported sensitivity and specificity of [[computed axial tomography|CT scan]] findings are in the range of 90-95%. CT is more sensitive than ultrasonography in the depiction of pericholecystic inflammatory response and in localizing pericholecystic abscesses, pericholecystic gas, and [[calculus (medicine)|calculi]] outside the [[lumen]] of the gallbladder.
CT scan findings associated with chronic cholecystitis include [[gallbladder wall thickening]], [[gallbladder]] distension or contraction and subserosal edema.


==CT scan==
==CT scan==
* CT scan is more specific than ultrasound. CT scan findings include:<ref name="Yun-">{{Cite journal  | last1 = Yun | first1 = EJ. | last2 = Cho | first2 = SG. | last3 = Park | first3 = S. | last4 = Park | first4 = SW. | last5 = Kim | first5 = WH. | last6 = Kim | first6 = HJ. | last7 = Suh | first7 = CH. | title = Gallbladder carcinoma and chronic cholecystitis: differentiation with two-phase spiral CT. | journal = Abdom Imaging | volume = 29 | issue = 1 | pages = 102-8 | month =  | year =  | doi = 10.1007/s00261-003-0080-4 | PMID = 15160762 }}</ref><ref name="pmid8615248">{{cite journal |author=Fidler J, Paulson EK, Layfield L |title=CT evaluation of acute cholecystitis: findings and usefulness in diagnosis |journal=[[AJR. American Journal of Roentgenology]] |volume=166 |issue=5 |pages=1085–8 |year=1996 |month=May |pmid=8615248 |doi= |url=http://www.ajronline.org/cgi/pmidlookup?view=long&pmid=8615248 |accessdate=2012-08-20}}</ref><ref name="urlCross-Sectional Imaging of Acute and Chronic Gallbladder Inflammatory Disease : American Journal of Roentgenology : Vol. 192, No. 1 (AJR)">{{cite web |url=https://www.ajronline.org/doi/abs/10.2214/AJR.07.3803 |title=Cross-Sectional Imaging of Acute and Chronic Gallbladder Inflammatory Disease : American Journal of Roentgenology : Vol. 192, No. 1 (AJR) |format= |work= |accessdate=}}</ref>
* CT scan is more specific than ultrasound. CT scan findings include:<ref name="Yun-">{{Cite journal  | last1 = Yun | first1 = EJ. | last2 = Cho | first2 = SG. | last3 = Park | first3 = S. | last4 = Park | first4 = SW. | last5 = Kim | first5 = WH. | last6 = Kim | first6 = HJ. | last7 = Suh | first7 = CH. | title = Gallbladder carcinoma and chronic cholecystitis: differentiation with two-phase spiral CT. | journal = Abdom Imaging | volume = 29 | issue = 1 | pages = 102-8 | month =  | year =  | doi = 10.1007/s00261-003-0080-4 | PMID = 15160762 }}</ref><ref name="pmid8615248">{{cite journal |author=Fidler J, Paulson EK, Layfield L |title=CT evaluation of acute cholecystitis: findings and usefulness in diagnosis |journal=[[AJR. American Journal of Roentgenology]] |volume=166 |issue=5 |pages=1085–8 |year=1996 |month=May |pmid=8615248 |doi= |url=http://www.ajronline.org/cgi/pmidlookup?view=long&pmid=8615248 |accessdate=2012-08-20}}</ref><ref name="urlCross-Sectional Imaging of Acute and Chronic Gallbladder Inflammatory Disease : American Journal of Roentgenology : Vol. 192, No. 1 (AJR)">{{cite web |url=https://www.ajronline.org/doi/abs/10.2214/AJR.07.3803 |title=Cross-Sectional Imaging of Acute and Chronic Gallbladder Inflammatory Disease : American Journal of Roentgenology : Vol. 192, No. 1 (AJR) |format= |work= |accessdate=}}</ref><ref name="pmid23541278">{{cite journal |vauthors=Kaura SH, Haghighi M, Matza BW, Hajdu CH, Rosenkrantz AB |title=Comparison of CT and MRI findings in the differentiation of acute from chronic cholecystitis |journal=Clin Imaging |volume=37 |issue=4 |pages=687–91 |year=2013 |pmid=23541278 |doi=10.1016/j.clinimag.2013.02.009 |url=}}</ref>
** Gallbladder wall thickening
** [[Gallbladder wall thickening]]
** Gallbladder distension or contraction
** [[Gallbladder]] distension or contraction
** Subserosal edema
** Subserosal edema
** High attenuation gallbladder bile
** High attenuation gallbladder bile
* CT cannot identify noncalcified gallbladder calculi, and cannot assess for [[Murphy's sign]].<ref name="Shea">Shea, JA, Berlin, JA, Escarce, JJ, et al. ''Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease''. Arch Intern Med 1994; 154:2573.</ref><ref name="Fink">Fink-Bennett, D, Freitas, JE, Ripley, SD, Bree, RL. ''The sensitivity of hepatobiliary imaging and real-time ultrasonography in the detection of acute cholecystitis''. Arch Surg 1985; 120:904.</ref>
* CT cannot identify noncalcified gallbladder calculi and cannot assess for [[Murphy's sign]].<ref name="Shea">Shea, JA, Berlin, JA, Escarce, JJ, et al. ''Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease''. Arch Intern Med 1994; 154:2573.</ref><ref name="Fink">Fink-Bennett, D, Freitas, JE, Ripley, SD, Bree, RL. ''The sensitivity of hepatobiliary imaging and real-time ultrasonography in the detection of acute cholecystitis''. Arch Surg 1985; 120:904.</ref>


===Acalculous Cholecystitis===
===Acalculous Cholecystitis===
The CT based diagnostic criteria from multiple studies for acalculous cholecystits is as follows.<ref name="Huffman-2010">{{Cite journal  | last1 = Huffman | first1 = JL. | last2 = Schenker | first2 = S. | title = Acute acalculous cholecystitis: a review. | journal = Clin Gastroenterol Hepatol | volume = 8 | issue = 1 | pages = 15-22 | month = Jan | year = 2010 | doi = 10.1016/j.cgh.2009.08.034 | PMID = 19747982 }}</ref>
The CT based diagnostic criteria from multiple studies for acalculous cholecystits is as follows:<ref name="Huffman-2010">{{Cite journal  | last1 = Huffman | first1 = JL. | last2 = Schenker | first2 = S. | title = Acute acalculous cholecystitis: a review. | journal = Clin Gastroenterol Hepatol | volume = 8 | issue = 1 | pages = 15-22 | month = Jan | year = 2010 | doi = 10.1016/j.cgh.2009.08.034 | PMID = 19747982 }}</ref>
{|class="wikitable"
{| class="wikitable"
! Criteria!! Diagnosis
! Criteria!! Diagnosis
|-
|-
Line 25: Line 26:
|}
|}


'''Diagnosis:''' 2 major or 1 major and 2 minor
'''Diagnosis:''' The diagnosis requires 2 major or 1 major and 2 minor to be positive.


==References==
==References==

Latest revision as of 19:53, 21 February 2018


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2], Furqan M M. M.B.B.S[3]

Chronic cholecystitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Cholecystitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Chronic cholecystitis CT On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Chronic cholecystitis CT

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Chronic cholecystitis CT

CDC on Chronic cholecystitis CT

Chronic cholecystitis CT in the news

Blogs on Chronic cholecystitis CT

Directions to Hospitals Treating Cholecystitis

Risk calculators and risk factors for Chronic cholecystitis CT

Overview

CT scan findings associated with chronic cholecystitis include gallbladder wall thickening, gallbladder distension or contraction and subserosal edema.

CT scan

Acalculous Cholecystitis

The CT based diagnostic criteria from multiple studies for acalculous cholecystits is as follows:[7]

Criteria Diagnosis
Major 3 to 4 mm wall thickness
Pericholecystic fluid
Subserosal edema
Intramural gas
Sloughed mucosa
Minor Hyperdense bile (sludge)
Subjective distension (hydrops)

Diagnosis: The diagnosis requires 2 major or 1 major and 2 minor to be positive.

References

  1. ↑ Yun, EJ.; Cho, SG.; Park, S.; Park, SW.; Kim, WH.; Kim, HJ.; Suh, CH. "Gallbladder carcinoma and chronic cholecystitis: differentiation with two-phase spiral CT". Abdom Imaging. 29 (1): 102–8. doi:10.1007/s00261-003-0080-4. PMID 15160762.
  2. ↑ Fidler J, Paulson EK, Layfield L (1996). "CT evaluation of acute cholecystitis: findings and usefulness in diagnosis". AJR. American Journal of Roentgenology. 166 (5): 1085–8. PMID 8615248. Retrieved 2012-08-20. Unknown parameter |month= ignored (help)
  3. ↑ "Cross-Sectional Imaging of Acute and Chronic Gallbladder Inflammatory Disease : American Journal of Roentgenology : Vol. 192, No. 1 (AJR)".
  4. ↑ Kaura SH, Haghighi M, Matza BW, Hajdu CH, Rosenkrantz AB (2013). "Comparison of CT and MRI findings in the differentiation of acute from chronic cholecystitis". Clin Imaging. 37 (4): 687–91. doi:10.1016/j.clinimag.2013.02.009. PMID 23541278.
  5. ↑ Shea, JA, Berlin, JA, Escarce, JJ, et al. Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease. Arch Intern Med 1994; 154:2573.
  6. ↑ Fink-Bennett, D, Freitas, JE, Ripley, SD, Bree, RL. The sensitivity of hepatobiliary imaging and real-time ultrasonography in the detection of acute cholecystitis. Arch Surg 1985; 120:904.
  7. ↑ Huffman, JL.; Schenker, S. (2010). "Acute acalculous cholecystitis: a review". Clin Gastroenterol Hepatol. 8 (1): 15–22. doi:10.1016/j.cgh.2009.08.034. PMID 19747982. Unknown parameter |month= ignored (help)


Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Chronic_cholecystitis_CT&oldid=1446911"