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Emergency Physicians have a high specificity and moderate sensitivity for detecting cholecystitis with point-of-care ultrasound.
Signs of Cholecystitis on Ultrasound include:
- Sonographic Murphy's sign = The patient has pain when the ultrasound probe is directed over the gallbladder and compressed
- Pericholecystic Fluid = Fluid around the gallbladder
- Increased Gallbladder Wall Thickness = A wall thickness > 3 mm measured on the anterior gallbladder wall
- Most patients will have gallstones. Acalculus cholecystitis can occur with patients who are chronically ill, critically ill, on TPN or immunocompromised.
References
Wilson SJ, Thavanathan R, Cheng W, Stuart J, Kim DJ, Glen P, Duigenan S, Shorr R, Woo MY, Perry JJ. Test Characteristics of Emergency Medicine-Performed Point-of-Care Ultrasound for the Diagnosis of Acute Cholecystitis: A Systematic Review and Meta-analysis. Ann Emerg Med. 2024 Mar;83(3):235-246. doi: 10.1016/j.annemergmed.2023.09.005.