In acute cholecystitis ultrasound will usually detect gallstones, inflammatory debris, gall bladder wall thickening and a rim of fluid adjacent to the gall bladder.
On CT, the gall bladder wall is thickened and there is surrounding inflammatory change seen as stranding in the adjacent fat. In acute cholecystitis, pain is often localized to the gall bladder. In chronic cholecystitis, the gall bladder is often contracted and thick-walled.
- Thickening of wall
- Granular fluid collection
- Positive sonographic Murphy’s Sign -
- otherwise, without these signs - its just a a stone with no acute manifisteation
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(A) Cholethiasis - showing acoustic shadow, hypo-echoic
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(B) US showing a thick, oedematous gall bladder wall indicated by the thin arrows. There is also evidence of fluid adjacent to the gall bladder indicative of acute inflammation
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(C) CT scan of acute cholecystitis showing a thick-walled gall bladder with adjacent oedema and inflammatory change as evidenced by a surrounding low attenuation rim and lack of clarity (stranding) in the adjacent fat .
if contracted gallbladder chronic