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[Diagnosis of acute cholecystitis. Ultrasound diagnosis is reliable]
1Abteilung Allgemeine Chirurgie mit Poliklinik, Chirurgische Universitätsklinik Freiburg. kohlberg@ch11.ukl.uni-freiburg.de
Abstract:
In the presence of typical ultrasonographic signs (Murphy's sign, established pericholecystitis) in patients with a relevant history and clinical presentation, diagnosis of acute cholecystitis can be established with a high degree of accuracy. As a non-invasive method, ultrasound can be used at the bedside of the severely ill patients, thus enabling the more economical use of more sophisticated and expensive examination methods. In the acute stage, the urgency of surgical intervention can be assessed. During follow-up, the effectiveness of conservative measures can be checked, failed treatment detected early on, and complications avoided. In high-risk patients, interventional procedures (puncture, percutaneous drainage) can be performed under US-control. Thus, US is the diagnostic modality of first choice for the diagnosis of acute cholecystitis. It has relevance for decision-taking, and is an indispensable procedure in the emergency setting.