Acute acalculous cholecystitis radiology

Acute acalculous cholecystitis refers to the development of cholecystitis in gallbladder either without gallstones or with gallstones where they are not the contributory factor. It is thought to occur most often due to biliary stasis and/or gallbladder ischaemia Acute Acalculous Cholecystitis: A Review. SUSAN STEPAN. SUSAN STEPAN. SUSAN STEPAN. Published Online: Apr 1 1994 https://doi.org/10.1148/radiology.191.1.68. More. Figures. References. Related

Acute acalculous cholecystitis. Kabra SK(1), Talati A, Shah R, Desai KD, Modi RR. Author information: (1)Department of Pediatrics and Radiology, V.S. General Hospital, Ahmedabad, Gujarat. PMID: 1800360 [PubMed - indexed for MEDLINE] Publication Types: Case Reports; MeSH Terms. Cefazolin/therapeutic use; Child, Preschool; Cholecystitis/diagnosis Sonogram (often sequential) and hepatic iminodiacetic acid scans are the most reliable modalities for diagnosis. It is generally agreed that cholecystectomy is the definitive therapy for AAC. However, at times a diagnostic/therapeutic drainage via interventional radiology/surgery may be necessary and life-saving, and may be the only treatment needed

Acute Acalculous Cholecystitis: A Review Radiolog

13.2 Acute Cholecystitis. Acute calculous cholecystitis carries a low risk of mortality in patients younger than 80 years, approximately 0.5%; however, the mortality risk can be as high as 11.6% in patients older than 80 years. 2 The pathogenesis involves a gallstone or biliary sludge obstructing the cystic duct, resulting in increased intraluminal pressure. This pressure, in combination with cholesterol supersaturated bile, triggers an inflammatory response Acute cholecystitis (AC) is severe inflammation of the gallbladder (GB) with intense abdominal pain dominating the clinical presentation. AC is divided into acute calculous cholecystitis (ACC) and acute acalculous cholecystitis (AAC). ACC represents over 90% of all AC cases, 1 initiated by a sentinel event of an obstructing gallstone in the. Because of the low positive predictive value, CT findings suggestive of acute cholecystitis should be interpreted with caution and should probably serve as justification for further investigation with abdominal ultrasound. CT has a relatively high negative predictive value (89%), and acute cholecystitis is unlikely in the setting of a negative CT

1. Radiology. 1986 Jul;160(1):33-8. Acute acalculous cholecystitis: sensitivity in detection using technetium-99m iminodiacetic acid cholescintigraphy. Swayne LC. Forty-one proved cases of acute acalculous cholecystitis imaged with technetium-99m iminodiacetic acid (IDA) cholescintigraphy were retrospectively analyzed Although the value of hepatobiliary scan and ultrasonography are well established in calculous cholecystitis, their role in acute acalculous cholecystitis (AAC) is less certain. This study assesses the diagnostic reliability of these tests in AAC chemically induced in 10 dogs with rutin, a compound known to induce AAC AAC is defined as an acute necroinflammatory disease of the gallbladder in the absence of cholelithiasis and has a multifactorial pathogenesis. 2, 3 It accounts for approximately 10% (range, 2%-15%) of all cases of acute cholecystitis Acute Acalculous Cholecystitis in Hospitalized Patients With Hematologic Malignancies and Prognostic Importance of Gallbladder Ultrasound Findings Rajesh Thampy MD , Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas Health Science Center, Houston, Texas, US

Acute acalculous cholecystitis

  1. Acute acalculous cholecystitis (AAC) is an acute inflammation of the gallbladder in the absence of stones. It accounts for 5 - 14 % of all cases of acute cholecystitis (AC) and tends to occur in critically ill patients [1 - 3]. Its pathogenesis is unclear to date
  2. e the outcomes of percutaneous cholecystostomy (PC) in patients with acute acalculous cholecystitis (AAC). Methods: The study population comprised 271 patients (mean age, 72 years; range, 22-97 years, male, n=169) with AAC treated with PC with or without subsequent cholecystectomy. Clinical data from total 271 patients were analysed, and outcomes were assessed according to whether the catheter was removed or remained indwelling
  3. Acute Acalculous Cholecystitis Due to Viral Hepatitis B: A Case Report. Omer A Mahmoud. 1, Mustafa Z Mahmoud. 2 * and Maram A Fagiri. 1. Medical Ultrasound Imaging Department, Dr. Mohamed Abdel Mageed Ali Medical Complex, Alnohood, Sudan. 2. Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bi
  4. SM Radiology Journal. Gr upSM. How to cite this article Mahmoud OA, Mahmoud MZ and Fagiri MA. Acute Acalculous Cholecystitis Due to Viral Hepatitis B: A Case Report. SM Radiol J. 2017; 3(1): 1012.OPEN ACCESS. IntroductionHepatitis B Virus (HBV) is a small (diameter of 42 nm), incompletely double-stranded DN
  5. The features of both CT and ultrasound are those of cholecystitis with no gallstones identified, in keeping with acute acalculous cholecystitis. Blood tests: GGT 81H IU/L ALT 55H IU/L AST 128H Bili Total 19 umol/L (ref <21
  6. istration of the radiosotope, and fails to show filling of the gallbladder. This finding confir

Less often, acute cholecystitis may develop without gallstones (acalculous cholecystitis). (See Overview of gallstone disease in adults, section on 'Natural history and disease course'.) This topic will review the pathogenesis, clinical manifestations, and diagnosis of acute calculous cholecystitis Kallifas Acute Acalculous Cholecystitis. Acute Cholecystitis - YouTube. Acute Cholecystitis - Core EM. Acute acalculous cholecystitis as the initial presentation of primary Cholecystitis | Radiology Reference Article | Radiopaedia.org. PPT - Pathology of the gall bladder and biliary tree PowerPoint. Acute acalculous cholecystitis (AAC) is defined as inflammation of the gallbladder without evidence of gallbladder calculi 1,2. Though relatively uncommon amongst the spectrum of biliary disease, AAC accounts for approximately 5-10% of cases of acute cholecystitis and has an incidence of 0.2-0.4% in critically ill patients 1,3,4 Acalculous cholecystitis is an inflammatory disease of the gallbladder without evidence of gallstones or cystic duct obstruction [1, 2] ; it is a severe illness that is a complication of various. Acute acalculous cholecystitis ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers

Acute acalculous cholecystitis: a revie

The patient was referred to the radiology department for pigtail tube insertion, after tube insertion pus came out. Her septicemia was dramatically reduced with total leukocytes counts reaches from initial 22,000 /mm3 to 9,000 /mm3. After 4 days.. Acute acalculous cholecystitis (AAC) is a dangerous complication of medical and surgical illnesses, and it is most commonly encountered in the intensive care setting. Although uncommon, recent repo..

Seventy-four cases of acalculous cholecystitis in infants and children (seven personal cases and 67 from the literature) were analyzed. In 45 cases the cholecystitis appeared as a complication of another illness. The primary illnesses in our patients were leptospirosis (four cases), diarrhea (two cases), and third-degree burns (one case) Acute cholecystitis refers to inflammation of the gallbladder and classically presents as a syndrome of right upper quadrant pain, fever, and leucocytosis. Gallstones are present in 7% of the population, and more common in women and with increasing age. Gallstones can cause biliary colic, acute cholecystitis and chronic cholecystitis General surgery consult if imaging shows acute cholecystitis for Cholecystectomy as cholecystectomy is the gold-standard treatment for patients with acute calculous cholecystitis. They usually admit under observation status as the patient can be discharged the next day if patient gets Laparoscopic Cholecystectomy soon enough

2. DEFINITION Inflammation of gall bladder is called ACUTE CHOLECYSTITIs. 3. INCIDENCE • COMMON IN FERTILE • FATTY • ABOVE FORTY • FEMALES lydia shum. 4. Etiology Obstruction Bacterial invasion Trauma and chemical irritation Pancreatic reflex. 5. Etiology 1 CALCULOUS. 6. etiology 2 ACALCULOUS Cholesterosis (strawberry gall bladder. Acalculous cholecystitis • Risk factors for acalculous cholecystitis include diabetes, human immunodeficiency virus (HIV) infection, vascular disease, total parenteral nutrition, prolonged fasting, or being an intensive care unit (ICU) patient. 6. Symptoms • Abdominal Pain. • Nausea, • Vomiting, • Low-grade fever 7 44 Acalculous Cholecystitis | Radiology Key radiologykey.com Ct Scan Acute Cholecystitis - ct scan machine luc.edu Acalculous Cholecystitis Imaging: Practice Essentials.

12 Acute Acalculous Cholecystitis Radiology Ke

Acute cholecystitis (AC) occurs as a result of inflammation of the gallbladder (GB) wall, usually because of obstruction of the cystic duct (see the image below). In 90% of cases, AC is initiated by the impaction of a calculus in the neck of the GB or in the cystic duct. [] Cholelithiasis affects approximately 20 million people in the United States each year, with 20% of symptomatic patients. The U.S. Department of Energy's Office of Scientific and Technical Informatio Acalculous Chobecystitis: Division, Palo Alto A Review. Medical Richard Clinic, Palo R. Babb, Alto, MD. CA Clin Gastroenterol 1992; 15:238-241. (Gas- troenterology 94301.) CUTE acalcubous flammation cholecystitis (AAC) is an acute inof the gallbladder with the absence of of different clinical disorders, the malities The criteria in patients that who signify had normal US examinations. are. Acute cholecystitis is a common surgical emergency and ultrasound (US) is currently considered the first-line diagnostic imaging test. The relative accuracy of computed tomography (CT) in detecting acute cholecystitis has received little attention in the literature. We report a case series of 113 patients who underwent emergency laparoscopic cholecystectomy at a tertiary surgical centre in.

Acute cholecystitis is a common diagnosis made in emergency departments throughout the world. While a majority of cases are caused by mechanical obstruction of the cystic duct by a calculous, a much smaller percentage are of the acalculous variety, typically 10% to 15% of all cases Acute acalculous cholecystitis (AAC) is characterised by acute necroinflammatory disease of the gallbladder without cystic duct obstruction due to gallstones [1,2,3].AAC occurs most frequently in critically ill patients such as after major surgery, trauma, anorexia, or burns, with incidence in this category ranging from 2% to 15% of all cases of acute cholecystitis [1, 4,5,6,7,8] Background Acute acalculous cholecystitis is a condition that usually occurs due to severe clinical status, it is relatively rare and hard to diagnose.A pathology that presents multifactorial etiology, it has been reported in the postoperative period, in burn patients and in association with sepsis, diabetes mellitus, vasculitis and parenteral nutrition

Acalculous Cholecystitis Imaging: Practice Essentials

  1. Coelho, JCU, Campos, ACL, Moreira, M, Moss, AA & Artigas, GV 1991, ' Acute acalculous cholecystitis ', International Surgery, vol. 76, no. 3, pp. 146-148
  2. Acute acalculous cholecystitis occurs especially in critically ill patients of trauma, sepsis or burns with a mortality rate between 10% and 90%, with an average of 30% as opposed to 1% in calculous cholecystitis. Patients of acalculous cholecystitis have a higher morbidity and mortality than those of acute calculous cholecystitis
  3. Acute acalculous cholecystitis (ACC) is a rare complication of acute viral hepatitis . Although the origin is obscure, demonstrated invasion of the gallbladder and bile duct epithelium by HAV and cell-mediated immunologic response have been proposed in the pathogenesis of HAV infection induced cholecystitis [ 3 , 4 ]
  4. antly in critically ill patients
  5. al emergencies: imaging and intervention in acute biliary conditions

Acute Cholecystitis: MR Findings and Differentiation from

  1. ology, etiology, and epidemiology of acute cholangitis and cholecystitis
  2. The symptoms of acalculous gallbladder disease are similar to those of acute (sudden, severe) cholecystitis that results from gallstones. Acute cholecystitis is a condition involving a severe inflammation of the gallbladder, it is usually caused by gallstones, but not always. Acalculous means without stones (calculi)
  3. Pediatr Radiol (1988) 18:421-423 Pediatric Radiology © Springer-Verlag 1988 M. Roca ~, N. Sellier 1, A. Mensire 2, G. Kalifa I and J. Bennet 1 Department of 1 Radiology and 2 Paediatrics, Hospital St. Vincent de Paul, Paris, France The following is a case report of acute acalculous cholecystitis in typhoid fever. The emphasis is on the value of sonography in making an accurate diagnosis of.
  4. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Acute Acalculous Cholecystitis. link. Bookmarks (0) Ultrasound. Diagnosis. Biliary System. Gallbladder Wall Pathology. Acute Acalculous Cholecystitis.
  5. Among trauma patients, about 90% of cases of acute cholecystitis are acalculous. 15 - 20 The percentage of cases of acute cholecystitis that are acalculous has increased significantly over time. 4 Because the incidence of the disease is low, but the many risk factors for the disease are common, it is difficult to identify specific groups of.

Figure 1. 37-year old female diagnosed as gallstones with acute cholecystitis. The incidental findings ; a: US image show multiple hypoechoic lesions, some of them with comet-tail artifacts, raises the possibility of multiple biliary hamartoma; b: T2-weighted MR image show numerous cystic lesions with signal similar to CSF; c: Post contrast T2 weighted MR image shows some of these lesions with. 역학. Acute acalculous cholecystitis는 미국에서 시행되는 담낭절제술의 5-10% 정도를 차지한다. 사실 수술 후 또는 외상이나 화상으로부터 회복중인 입원 중 환자들에서 이행되는 담낭절제술 중에서는 절반 이상이 acalculous disease이다 When the acalculous cholecystitis is complicated by empyema of gallbladder, the patient becomes more toxic, with high spiking fever, chills, and finally septic shock. The diagnosis of acute acalculous cholecystitis as a complication of salmonellosis is based on clinical, laboratory, and radiological findings Acute Cholecystitis: Etiology. Risk factors for calculous cholecystitis mirror those of cholelithiasis and include the following: Female sex. Certain ethnic groups. Obesity or rapid weight loss. Drugs (especially hormonal therapy in women) Pregnancy. Increasing age. Acalculous cholecystitis is related to conditions associated with biliary.

The Radiology Assistant : Gallbladder wall thickenin

Another form of cholecystitis, acute acalulous cholecystitis (AAC) is an inflammatory disease of the gallbladder without evidence of gallstones or obstruction of the cystic ducts. Approximately 2-15% of cases of cholecystitis are acalculous and usually occur in very sick hospitalized patients Background: Acute acalculous cholecystitis (AAC) is a serious complication of critical illness. We evaluated the underlying diseases, clinical and diagnostic features, severity of associated organ f.. Her presentation exhibited an evolving clinical picture of acalculous cholecystitis with the radiological pattern of progressive gall bladder wall thickening, pericholecystic fluid collection, and a positive radiological and clinical Murphy sign. SARS-CoV-2 infection can cause acalculous acute cholecystitis Although the value of hepatobiliary scan and ultrasonography are well established in calculous cholecystitis, their role in acute acalculous cholecystitis (AAC) is less certain. This study assesses the diagnostic reliability of these tests in AAC chemically induced in 10 dogs with rutin, a compound known to induce AAC. Ultrasonography demonstrated pericholecystic fluid or wall thickening in 8.

I was having a very bad day. It started with a call from my primary care physician saying I had high liver enzymes and needed an ultrasound of my liver/gallb.. Acute Acalculous Cholecystitis in Typhoid Fever Acute acalculous cholecystitis is an acute inflammation of the gall bladder without stones. It was once considered a rare complication of typhoid fever(l), and was rarely diagnosed pre-operatively before the advent of ultra-sound(2). Recent studies using ultra-sound have, however, shown that th Acute acalculous cholecystitis (AAC) represents inflammation of the gallbladder in the absence of demonstrated calculi (see the encoded search term (Acalculous Cholecystitis Imaging) and Acalculous Cholecystitis Imaging What to Read Next on Medscape. As a result, some authors propose the term necrotizing cholecystitis to reflect the fact that acalculous cholecystitis does not. Ultrasound of acute & chronic cholecystitis slidesharecdn.com. Role of cholescintigraphy in management of acute ijnm.in. Figure 1 from Hepatobiliary scan findings in chronic amazonaws.com. Acalculous cholecystitis | Radiology Case | Radiopaedia.org radiopaedia.org. Acute acalculous cholecystitis is inflammation of the gallbladder without any evidence of gallstones. Although acalculous cholecystitis is less common than its calculous counterpart, it can be fatal if not treated. It is essential to rule out the cause of acalculous cholecystitis to aid in the treatment and management of the patient. We present a case of acalculous cholecystitis wherein a.

Imaging of Cholecystitis : American Journal of

  1. Acalculous cholecystitis is responsible for approximately 5-10 percent of all cases of acute cholecystitis, an inflammatory disease of the gallbladder. The majority of acute cholecystitis cases.
  2. Acalculous cholecystitis is a hypokinetic condition of gallbladder emptying. It often presents as an acute ailment (acute cholecystitis), but it can also exhibit more chronic (chronic cholecystitis) symptoms. Acalculous cholecystitis is a life-threatening disorder that has a high risk of perforation and necrosis compared to the more typical.
  3. Results: Cholecystitis was a fairly frequent finding in critically ill trauma patients (67 of 2,625 patients, 2.6%). Almost 10% of the patients with severe multiple injuries developed cholecystitis. Histologic findings showed a wide variation; three main diagnoses were established: acute acalculous cholecystitis (n = 28), chronic acalculous.
  4. Acute acalculous cholecystitis Radiology Reference. Feb 14, 2019 · Acalculous cholecystitis is an inflammatory disease of the gallbladder without evidence of gallstones or cystic duct obstruction [1, 2]; it is a severe illness that is a complication of various other medical or surgical conditions.Duncan first recognized it in 1844 when a fatal case of acalculous cholecystitis complicating an.
  5. Acute acalculous cholecystitis (AAC) is defined as acute necroinflammatory disease of gallbladder (GB), in the absence of cholelithiasis, and has multifactorial pathogenesis. It is clinically indistinguishable from acute calculous cholecystitis. AAC is the epiphenomenon (secondary manifestation) of various primary disease pathophysiology

Article - Acute perforated acalculous cholecystiti

The radiology assistant gallbladder wall thickening. Acalculous cholecystitis. Acute acalculous cholecystitis especially takes place in significantly unwell sufferers, possibly due to extended bile viscosity from fasting and. Gallbladder surgical procedure no insurance surgical procedure. Gallbladder surgical procedure is the therapy for all. Radiology diagnostics and treatment of acute cholecystitis. Ugeskr Læger 2017;179:V02170126. Acute cholecystitis (A C) is mainly caused by stones in the. gall bladder. Although cholescintigraph y. Radiology. 1984. Aug;152(2):365-7. 28. Gallbladder tissue from patients with acute acalculous cholecystitis contains increased amounts of prostanoids when compared to normal gallbladder tissue.

ACUTE ACALCULOUS CHOLECYSTITIS RADIOLOGY PEARLS ACUTE ACALCULOUS CHOLECYSTITIS: ESSENTIAL FACTS ABOUT ACUTE ACALCULOUS CHOLECYSTITIS: Acute acalculous cholecystitis is inflammation of the gallbladder without gallstones and represents only upto 5% of cases of cholecystitis. Untreated Acute acalculous cholecystitis progresses rapidly and has a very high risk of mortality Case Discussion. US findings are consistent with acute cholecystitis. Especially, asymmetrical wall thickness with ulceration is suggestive of the gangrenous gallbladder.. Percutaneous cholecystostomy, which is a safe and effective procedure in high-risk patients was done until the stabilization of a patient to enable a more measured surgical approach Acute Acalculous Cholecystitis Philip S. Barie, KEYWORDS Acute acalculous cholecystitis Percutaneous cholecystostomy Ultrasound CT MD, MBA a,b, *, Soumitra R. Eachempati

13 Acute Cholecystitis, Cholelithiasis - Radiology Ke

Acute acalculous cholecystitis (AAC) represents inflammation of the gallbladder in the absence of demonstrated calculi (see the image below). Assistant Chief, Interventional Radiology and Diagnostic Radiology, Walter Reed Army Medical Center Nick Lomis, MD is a member of the following medical societies: American College of Radiology, Department of Radiology Acute acalculous cholecystitis protocol CCK? Administer Choletec CCK? Tc-99m or In-111 WBC? Administer tagged-WBCs Re-image if Tc-99m WBC given Hrs -0.5 0 1 2 3-4 6 Exclusion of false-negative outline Re-image if In-111 WBC given . MIPS Stanford University.

Applied hepatobiliary scintigraphy in acute cholecystiti

Role of percutaneous cholecystostomy for acute acalculous cholecystitis: clinical outcomes of 271 patients. Eur Radiol. (2018) 28:1449-55. doi: 10.1007/s00330-017-5112- Acute cholecystitis (AC) is a life-threatening emergency that commonly occurs as a complication of gallstones. Severe right upper quadrant pain, abdominal guarding, fever, and a positive Murphyʼs sign with an elevated white blood cell count are the classical clinical manifestations of AC. Although ultrasonography is typically the initial diagnostic examination in patients with suspected AC. Eventhough acute cholecystitis is a common entity, GB perforation is rare and rarer still is its intrahepatic perforation. GB perforation is commoner in males. Risk of perforation is more in acalculous cholecystitis due to sepsis and associated co-morbidities Recurrent inflammation of the gallbladder secondary to chronic stone disease and stasis is bound to present with multiple intermittent flare ups. Cholecystitis can result in complications like subsegmental portal vein thrombosis. Long standing in..

FD: FINAL DIAGNOSIS Gallbladder hydrops DIFFERENTIALAcalculous cholecystitis | Radiology Case | Radiopaedia

CT Findings of Acute Cholecystitis and Its Complications

5 Owen CC, Jain R. Acute acalculous cholecystitis. Curr Treat Options Gastroenterol 2005; 8 (02) 99-104 ; 6 Kalliafas S, Ziegler DW, Flancbaum L, Choban PS. Acute acalculous cholecystitis: incidence, risk factors, diagnosis, and outcome. Am Surg 1998; 64 (05) 471-475 ; 7 Boland GW, Lee MJ, Leung J, Mueller PR Oct 29, 2017 - The features of both CT and ultrasound are those of cholecystitis with no gallstones identified, in keeping with acute acalculous cholecystitis. Blood tests: GGT 81H IU/L ALT 55H IU/L AST 128H Bili Total 19 umol/L (ref <21 Acute acalculous cholecystitis (AAC) is defined as acute inflammatory process of the gallbladder without evidence of gallstones contributing to 5-10% of all cholecystitis . Acute acalculous cholecystitis is typically seen in hospitalized patients with sepsis, burns, and trauma; those with prolonged use of total parenteral nutrition; and older. Definition: Acute inflammation of the gallbladder Variant Forms. Acalculous cholecystitis (10% of cases): Inflammation of the gallbladder in the absence of gallstones or cystic duct obstruction that is more common in older patients and after non-biliary tract surgery; Emphysematous cholecystitis (1% of cases): Inflammation of the gallbladder along with the presence of gas in the gallbladder wall Objective To evaluate acute acalculous cholecystitis (AAC) as a potential safety risk for patients treated with alemtuzumab. Methods The Food and Drug Administration Adverse Event Reporting System and the medical literature were searched for cases of AAC in conjunction with alemtuzumab for all clinical indications. Results Eight spontaneously reported cases meeting the case definition of AAC.

Acalculous cholecystitis. Acalculous cholecystitis is a confusing entity. True acalculous, non-obstructive cholecystitis is extremely rare and is the result of primary ischemic necrosis of the gallbladder due to an episode of low-flow state, comparable with non-obstructive mesenteric ischemia (NOMI) leading to small bowel infarction Although recognized for more than 150 years, acute acalculous cholecystitis (AAC) remains an elusive diagnosis. This is likely because of the complex clinical setting in which this entity develops, the lack of large prospective controlled trials that evaluate various diagnostic modalities, and thus dependence on a small data base for clinical decision making Acute acalculous cholecystitis (AAC) diagnosed usually by US finding of thick gallbladder wall and free fluid around it without gallstones . Its relatively rare in paediatrics and can be classified into three categories: (1) Related to critical medical conditions, like sepsis, post-surgery, and prolonged total parenteral nutrition

Acute cholecystitis | Image | RadiopaediaHepatic abscess related to acute cholecystitis | RadiologyFrontiers | Synchronous Acute Acalculous Cholecystitis andCholecystitis Ct Scan - ct scan machine

4. Cohan RH, et al. Striated intramural gallbladder lucencies on US studies: predictors of acute cholecystitis. Radiology. 1987; 164(1):31-5. 5. Schiller VL, et al. Color Doppler imaging of the gallbladder wall in acute cholecystitis: sono-pathologic correlation. Abdom Imaging. 1996; 21(3):233-7. 6 (Right) This hepatobiliary scan is of a 48-year-old woman with RUQ pain and surgically confirmed acute cholecystitis. Note the presence of bowel , absence of GB activity, and a subtle GB fossa rim sign .Persistent pericholecystic activity may be due to tissue edema and biliary stasis The patient was diagnosed with acute acalculous cholecystitis and a multidisciplinary team including general surgery unit, interventional radiology unit, intensive care unit and infectious disease unit, had discussed the therapeutic choices for patient