Pediatric Acute Cholecystitis

  • Etiology: Gallstones causing obstruction of the biliary tree
  • Imaging US:
    — Gallbladder wall thickening
    — Pericholecystic fluid and edema
    — Gallstones
    — Sonographic Murphy’s sign
    — Often an obstructing gallstone is seen in cystic duct
  • DDX:
  • Complications:
  • Treatment: Surgical
  • Clinical: Right upper quadrant pain

Radiology Cases of Acute Cholecystitis

CT and US of acute cholecystitis
Axial (above left) and sagittal (above right) CT with contrast of the abdomen shows an enlarged gallbladder with diffuse wall thickening and pericholecystic fluid. Transverse (below left) and sagittal (below right) US of the abdomen again shows gallbladder wall thickening and pericholecystic fluid and a large amount of sludge in the gall bladder.
CT and US of acute cholecystitis
Axial CT with contrast of the abdomen (above) shows a distended gall bladder with gallbladder wall thickening with rim enhancement. Sagittal US of the gallbladder shows diffuse wall thickening of the gallbladder (below left) along with a stone in the neck of the gallbladder causing posterior acoustic shadowing (below right).