Martinez reported sonographic findings associated with acute cholecystitis developing after surgery on a system other than the biliary system. These same sonographic finding can be applied to types of acute cholecystitis. The authors are from Universidad Autonoma Barcelona in Spain.
Criteria for calling acute cholecystitis postoperative:
(1) antecedent operation, not on the gallbladder or biliary tract
(2) onset within 2 weeks of surgery
Parameters:
(1) distention of the gallbladder
(2) gallbladder wall thickness
(3) cholelithiasis
(4) sonolescent halo in the gallbladder wall
(5) fluid sonolucent band surrounding the gallbladder
(6) intraluminal echogenic mass with no posterior acoustic shadow
|
Parameter |
Finding |
Points |
|
distention of the gallbladder |
absent |
0 |
|
|
present (>= 5 cm across) |
1 |
|
gallbladder wall thickness |
< 5 mm |
0 |
|
|
>= 5 mm |
1 |
|
cholelithiasis |
absent |
0 |
|
|
present |
1 |
|
sonolescent halo in the gallbladder wall |
none |
0 |
|
|
focal or continuous |
1 |
|
fluid sonolucent band surrounding the gallbladder |
absent |
0 |
|
|
present |
1 |
|
intraluminal echogenic mass with no posterior shadow |
absent |
0 |
|
|
present |
1 |
total number of findings =
= SUM(points for all 6 parameters)
Interpretation:
• minimum number of findings: 0
• maximum number of findings: 6
• The higher the number of findings the more likely that acute cholecystitis is present.
• In the author's series the patients with acute postoperative cholecystitis had 3 or more findings present.
Specialty: Gastroenterology, Surgery, general
ICD-10: ,
