02Nov 2018

ULTRASOUND AS A FIRST LINE INVESTIGATION OF CHOICE IN DIAGNOSIS OF ACUTE CHOLICYSTITIS.

  • Head of Department, Pharmacology, Senior Sonologist, Department of Radiology. Jinnah Medical & Dental College. Medicare Hospital.
Crossref Cited-by Linking logo
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Aim: Aim of our study to diagnose acute cholicystitis on ultrasound as a first line investigation to prevent patient from developing complications like duct obstruction, perforation and gangrenous gallbladder due to impaction of stones in the ducts. Material & Methods: Ultrasound is the method of choice for detection for the detection of gall bladder pathology , sonologically it can best be appreciated / comment on gallbladder wall (increased when above 3.5mm), lumen, impaction of stones in lumen and fluid around gallbladder. Total of 20 patients in month of October, 2018 were included who came from emergency, OPD and ward to Radiology department of Medicare Cardiac & General hospital with complaints of right hypochondriac/ epigastric pain, loss of appetite, nausea, vomiting. Results: out of total of 20 patients , all had complaint of right upper hypochondrial pain. Sixteen patients(80%) two had thickened wall with stones (10%) one had thickened wall, fluid around gallbladder(5%) with stones and one patients ultrasound image showed contracted gallbladder due to chronic cholecystitis (5%). Two patients had cholecystitis without stones. Conclusion: Ultrasound has been a most useful tool for detecting gallbladder pathology such as acute cholecystitis with or without cholithiasis with accuracy.

  1. Antonio Pinto, Alfonso Reginelli, Lucio Cagini, Francesco Coppolino, Antonio Amato Stabile Ianora, Renata Bracale,6 Melchiore Giganti,7 and Luigia Romano Accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis: review of the literature. Crit Ultrasound J. 2013; 5(Suppl 1): S11.
  2. Menu Y, Vuillerme M-P. In: Emergency Radiology. Marincek B, Dondelinger RF, editor. Springer-Verlag Berlin Heidelberg; 2007. Non-traumatic abdominal emergencies: imaging and intervention in acute biliary conditions; pp. 481?491. Imaging and Intervention.
  3. Zeman RK. In: Textbook of gastrointestinal radiology. Gore RM, Levine MS, Laufer I, editor. Philadelphia, PA, PA: Saunders; 1994. Cholelithiasis and cholecystitis; pp. 1636?1674.
  4. Bortoff GA, Chen MY, Ott DJ, Wolfman NT, Routh WD. Gallbladder stones: imaging and intervention. RadioGraphics. 2000;5:751?766.
  5. Watanabe Y, Nagayama M, Okumura A. et al. MR imaging of acute biliary disorders. RadioGraphics. 2007;5:477?495. doi: 10.1148/rg.272055148.
  6. Trowbridge RL, Rutkowski NK, Shojania KG. Does this patient have acute cholecystitis. JAMA. 2009;5:80?86.
  7. Nino-Marcia M, Jeffrey RB Jr. Imaging the patient with right upper quadrant pain. Semin Roentgenol. 2001;5:81?91. doi: 10.1053/sroe.2001.22825.
  8. Schiller VL, Turner RR, Sarti DA. Color doppler imaging of the gallbladder wall in acute cholecystitis: sonographic-pathologic correlation. Abdom Imaging. 1996;5:233?237. doi: 10.1007/s002619900053.
  9. Paulson EK, Kliewer MA, Hertzberg BS, Paine SS, Carroll BA. Diagnosis of acute cholecystitis with color Doppler sonography: significance of arterial flow in thickened gallbladder wall. Am J Roentgenol. 1994;5:1105?1108. doi: 10.2214/ajr.162.5.8165991.
  10. Shea JA, Berlin JA, Escarce JJ, Clarke JR, Kinosian BP, Cabana MD, Tsai WW. et al. Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease. Arch Intern Med. 1994;5(22):2573?2581. doi: 10.1001/archinte.1994.00420220069008.
  11. Lorusso F, Fonio P, Scardapane A, Giganti M, Rubini G, Ferrante A, Stabile Ianora AA. Gatrointestinal imaging with multidetector CT and MRI. Recenti Prog Med. 2012;5(11):493?9.
  12. Reginelli A, Pezzullo MG, Scaglione M, Scialpi M, Brunese L, Grassi R. Gastrointestinal disorders in elderly patients. Radiol Clin North Am. 2008;5(4):755?71. doi: 10.1016/j.rcl.2008.04.013.
  13. Laing FC, Federle MP, Jeffrey RB, Brown TW. Ultrasonic evaluation of patients with acute right upper quadrant pain. Radiology. 1981;5(2):449?455.
  14. Ralls PW, Colletti PM, Lapin SA. et al. Real-time sonography in suspected acute cholecystitis: prospective evaluation of primary and secondary signs. Radiology. 1985;5:767?771.
  15. Imhof M, Raunest J, Ohmann C, R?her HD. Acute acalculous cholecystitis complicating trauma: a prospective sonographic study. World J Surg. 1992;5(6):1160?1165. doi: 10.1007/BF02067089.

[Samia Perwaiz Khan and Safia Izhar. (2018); ULTRASOUND AS A FIRST LINE INVESTIGATION OF CHOICE IN DIAGNOSIS OF ACUTE CHOLICYSTITIS. Int. J. of Adv. Res. 6 (Nov). 65-69] (ISSN 2320-5407). www.journalijar.com

Samia Perwaiz Khan
Jinnah Medical & Dental College

DOI:

Article DOI: 10.21474/IJAR01/7972      
DOI URL: http://dx.doi.org/10.21474/IJAR01/7972

Download Full Paper

Download PDF No. of Downloads: 22 | No. of Views: 104