Which ultrasound findings are characteristic of biliary colic and acute cholecystitis?

Updated: Jan 18, 2017
  • Author: Peter A D Steel, MBBS, MA; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Findings include gallstones or sludge and one or more of the following conditions:

  • Gallbladder wall thickening (>2-4 mm) - False-positive wall thickening found in hypoalbuminemia, ascites, congestive heart failure, and carcinoma

  • Gallbladder distention (diameter >4 cm, length >10 cm)

  • Pericholecystic fluid from perforation or exudate - May be seen as a hypoechoic or anechoic region seen along the anterior surface of the gallbladder within the hepatic parenchyma

  • Air in the gallbladder wall (indicating gangrenous cholecystitis)

  • Ultrasonographic Murphy sign (86-92% sensitive, 35% specific) - pain when the probe is pushed directly on the gallbladder (not related to breathing)

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