Plain abdominal x-ray is of no real benefit apart from looking for other pathologies. Only 10% of gall stones will show up on x-ray.

Ultrasound scan can pick up gall stones of 1-2 mm diameter within the gall bladder with 95% sensitivity and 97% specificity. Due to overlying bowel gas it may miss 25-40% of bile duct stones.

Acute cholecystitis can be identified on ultrasound scan by thickened gall bladder wall, pericholecystic fluid and a sonographic Murphy’s sign.

CT and plain radiology are not generally helpful in the diagnosis of acute cholecystitis.

The ultrasound scan shows the gall bladder in acute cholecystitis. The measurement A-A is greater than 6 mm which means the gall bladder wall is swollen and the white area below the measure A-A is a gall stone.

Learning Bite

The most important tools for diagnosis of acute cholecystitis are clinical suspicion and ultrasound scan [10-11].

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