The ultrasound spectrum of emphysematous cholecystitis

Abstract

This report presents a gamut of ultrasound signs that may be seen in emphysematous cholecystitis. These can be summarized as follows: Intraluminal gas: (a) A dense band of hyper-reflective echoes with distal reverberations when gallbladder is full of gas. (b) A band of reverberations in the gas-filled portion of the gallbladder with the usual signs of cholecystitis in the bile-filled portion when the gallbladder is partially full of gas. Intramural gas: (c) An area of high reflectivity in the gallbladder wall with reverberations that may change position with change in position of patient. (d) A bright hyper-reflective ring emanating from the whole circumference of the gallbladder.

Emphysematous cholecystitis: Imaging findings in nine patients

“…[8] High pressure in the GB/biliary system and consequent compression of blood vessels in the GB wall, obstruction of the cystic artery at hepatic artery embolization, atheromatous embolism of the cystic artery after an abdominal aortogram,[10–12] and hypoperfusion of the GB during cardiopulmonary resuscitation have all been known to result in EC.…”

Soft Tissue Gas Gangrene: A Severe Complication of Emphysematous Cholecystitis

“…Imaging studies, including abdominal X-rays, ultrasonography and computed tomography of the abdomen, point out air accumulation in the gallbladder wall which is the pathognomonic sign for the diagnosis of the disease (Blaquire and Dewbury 1982;Andreu et al 1987;Brandon et al 1988;Hawass 1988;Bloom et al 1989).…”

Evaluating Patients with Right Upper Quadrant Pain

“…Ultrasonography findings vary depending on the amount and location of gas. 170,171 A small amount of gas in the gallbladder wall may appear as an echogenic focus with associated ring-down or comet-tail artifact. Larger amounts of intramural gas and intraluminal gas may appear as a curvilinear arc of increased echogenicity with associated so-called "dirty" posterior acoustic shadowing that obscures the gallbladder fossa (Fig.…”