Diagnostic Methods for Acute Cholecystitis
May 31, 2019
Source: Cainiu Health
Dr. Li Feng
Introduction
The diagnostic methods for acute cholecystitis are as follows:
1. Distinct clinical manifestations: Gallstones can damage the gallbladder mucosa, triggering intense gallbladder contractions and resulting in severe, colicky pain.
2. Ultrasonography (B-mode ultrasound);
3. Computed tomography (CT) or magnetic resonance imaging (MRI).
Diagnostic methods for acute cholecystitis are as follows:
1. Distinct clinical manifestations: Gallstones can damage the gallbladder mucosa, triggering intense gallbladder contractions and resulting in severe, colicky pain akin to being cut by a knife.
2. Ultrasound (B-mode ultrasound): The first-line imaging modality in clinical practice, offering advantages of convenience, affordability, cost-effectiveness, and speed. Its diagnostic accuracy for gallstones exceeds 90%. However, postprandial gallbladder distension may limit ultrasound visualization of stones.
3. Computed tomography (CT) or magnetic resonance imaging (MRI): Used when ultrasound is inconclusive or technically limited; CT or MRI provides highly intuitive and clear visualization of gallbladder and biliary tract anatomy and integrity.
Etiology:
1. Mechanical inflammation
Caused by elevated intraluminal pressure within the gallbladder, leading to compression-induced ischemia of the gallbladder wall and mucosa.
2. Chemical inflammation
Phospholipase acts on lecithin in bile, generating lysophosphatidylcholine, which induces chemical inflammation.
3. Bacterial inflammation
Occurs due to bacterial colonization of the gallbladder by organisms such as Escherichia coli, Klebsiella species, Streptococcus, and Staphylococcus. Bacterial infection accounts for 50–80% of cases of acute cholecystitis.
