Diagnostic studies- cholecystitis

• RUQ U/S: high Se & Sp for stones, but need specific signs of cholecystitis:

Note

GB wall thickening >4 mm, pericholecystic fluid and a sonographic Murphy’s sign 厚水痛

guidelines for the diagnosis and determination of severity of acute cholecystitis

HIDA scan:

most Se test (80–90%) for acute cholecystitis.

• HIDA scan stands for hepatobiliary iminodiacetic acid scan.

• It is a diagnostic test used to assess the function of the gallbladder and bile ducts.

• It is considered the most sensitive (80-90%) test for acute cholecystitis, which is an inflammation of the gallbladder.

• During the test, a radioactive material and a chemical that helps highlight the bile ducts are injected into the patient’s body.

• Images are then taken using a special camera to detect the movement of the material and the flow of bile, allowing doctors to diagnose any issues with the gallbladder or bile ducts.

• IV inj of HIDA (selectively secreted into bile).

• ⊕ if HIDA enters BD but not GB.

• 10–20% false ⊕ (cystic duct obstructed 2/2 chronic cholecystitis, lengthy fasting, liver disease).