What are the advantages and disadvantages of ultrasonography for the evaluation of acute cholangitis?

Updated: Dec 29, 2017
  • Author: Timothy M Scott, DO; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Consider the following:

  • Transabdominal ultrasonography is the initial imaging study of choice.

  • Ultrasonography can differentiate intrahepatic obstruction from extrahepatic obstruction and image dilated ducts.

  • In one study of cholangitis, only 13% of CBD stones were observed on ultrasonography, but dilated CBD was found in 64%.

  • Advantages to sonography include the ability to be performed rapidly at the bedside by the ED physician, capacity to image other structures (eg, aorta, pancreas, liver), identification of complications (eg, perforation, empyema, abscess), and lack of radiation.

  • Disadvantages to sonography include operator and patient dependence, cannot image the cystic duct, and decreased sensitivity for distal CBD stones.

  • A normal sonogram does not rule out acute cholangitis.


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