How does acute cholecystitis manifest on Ultrasound?
The sonographic features of acute cholecystitis include gallbladder distention (>4 cm), gallbladder wall thickening (>3 mm) and hyperemia, gallstones (especially if impacted at the gallbladder neck or in the cystic duct), pericholecystic fluid, and a positive sonographic Murphy’s sign (focal tenderness over the gallbladder when compressed by the US transducer). The combination of gallstones and a positive Murphy’s sign has a positive predictive value of 92% and a negative predictive value of 95% for acute cholecystitis.
