Intravenous Cholangiography in the Differential Diagnosis of Acute Cholecystitis

Johnson, Henry C.; McLaren, John R.; Weens, H. Stephen

doi:10.1148/74.5.790

Cited by 36 publications

(5 citation statements)

References 4 publications

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“…The results are in accordance with those of previous authors (4,5,15,18,20,29) and indicate that when contrast medium, excreted to the biliary system, can be identified at conventional cholangiography the diagnostic accuracy of this method is high in supporting or contradicting the clinical diagnosis of acute cholecystitis. False negative results are rare and in false positive cases, cystic duct obstruction is generally caused by fibrosis secondary to chronic cholecystitis, calculi or tumor.…”

Section: Discussionsupporting

confidence: 92%

“…Furthermore distension of the gallbladder in patients with acute cholecystitis with secondary compression of the extrahepatic bile ducts may reduce the hepatic excretion capacity (7). It is thus not surprising that in several investigations the majority of patients without demonstration of the biliary system in fact suffers from acute cholecystitis (15,18,20). This indi- Fig.…”

Section: Discussionmentioning

confidence: 95%

“…The method has a high diagnostic accuracy when excreted contrast medium is identified in the biliary system or duodenum (4,5,15,18,20,29). However, if no contrast medium is detected, which occurred in 8 to 40 per cent in the above mentioned studies, the examination is of no diagnostic value.…”

mentioning

confidence: 99%

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Intravenous Computed Tomographic Cholangiography in Acute Cholecystitis

Nyman¹,

Rimér²,

Aspelin³

et al. 1984

Acta Radiologica. Diagnosis

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Forty-nine patients with clinical signs of acute cholecystitis underwent conventional and computed tomographic cholangiography. Among 39 patients with signs of contrast medium in the biliary system at both examinations there was a diagnostic discrepancy in only one patient. Conventional radiography demonstrated cholecystopathy in this patient while contrast medium in the gallbladder and an acute pancreatitis were found at computed tomography. Ten patients with an indeterminate conventional cholangiography had a conclusive computed tomographic examination. Twenty of 30 patients with an abnormal computed tomographic cholangiography underwent cholecystectomy and all had diseased gallbladders. All 17 patients with histopathologically confirmed acute cholecystitis had signs of subserosal edema and/or changes in the omental fatty tissue adjacent to the gallbladder at computed tomography. A layer of tissue of water-density adjacent to the gallbladder and/or changes in omental fatty tissue were also seen in one patient with congestive heart failure and in one with a penetrating duodenal ulcer. None of the 19 patients with a normal computed tomographic cholangiography had a proven acute cholecystitis.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 95%

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Intravenous Computed Tomographic Cholangiography in Acute Cholecystitis

Nyman¹,

Rimér²,

Aspelin³

et al. 1984

Acta Radiologica. Diagnosis

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“…In the case of acute cholecystitis, intravenous cholangiography has an established position [32][33][34]. This method has some limitations, however, mainly depending on liver function [32].…”

Section: Discussionmentioning

confidence: 99%

“…This method has some limitations, however, mainly depending on liver function [32]. According to Thorpe et al [35], opacification of the biliary system occurred in 96% of patients with adequate liver function if the cases with biliary system appearance after 24 h were included.…”

Section: Discussionmentioning

confidence: 99%

Infusion tomography and ultrasonography of the gallbladder in the diagnosis of acute cholecystitis

Karp

Herlin

Holmin

et al. 1979

Gastrointest Radiol

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Sixty-three patients with the clinical suspicion of acute cholecystitis were examined with infusion tomography of the gallbladder. Ultrasonography was performed in 51 of these cases. The technique and diagnostic principles of both methods are discussed. The diagnostic value of the two methods when used in combination is stressed. Thus in a case of gangrenous cholecystitis when opacification of the gallbladder wall may not appear at infusion tomography, ultrasonography may demonstrate signs of gallbladder disease. Infusion tomography, on the other hand, may be of great value if ultrasonography is not informative.In acute cholecystitis there is reason to believe that surgical intervention should be carried out as early as possible in order to reduce mortality [1-4]. The need for rapid and reliable diagnostic methods is therefore obvious. If the patient has a history of repeated attacks of biliary colic and is admitted to the hospital with fever, pain, and tenderness localized in the right upper quadrant of the abdomen, the diagnosis of acute cholecystitis is likely, at least if earlier cholecystography has proved the presence of cholelithiasis and/or nonfunctioning gallbladder. In such instances, there is seldom need for further diagnostic considerations before operative intervention. However, many patients with acute cholecystitis have no history of abdominal pain and the clinical diagnosis is not firm enough to indicate an acute operation.

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