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The Diagnosis of Acute Cholecystitis

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Acute Cholecystitis

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Abstract

Diagnosis of acute cholecystitis involves clinical, laboratory, and radiographic findings. The Tokyo Guidelines for the Management of Acute Cholangitis and Cholecystitis (TG13) provide a diagnostic algorithm that optimizes specificity and sensitivity in those patients with a history suggestive of possible acute cholecystitis. Physical exam and laboratory findings should suggest acute inflammatory processes. Imaging should start with RUQ ultrasound and include HIDA if inconclusive. For patients with atypical symptoms, CT may be a better initial imaging modality. The role of MRI is less clear, but may become more important as radiation exposure concerns grow. In select patient populations and certain clinical settings, diagnosis may be difficult or delayed. A high index of suspicion and an attentive approach in at-risk populations is required to limit delays in diagnosis and possible complications.

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Author information

Authors and Affiliations

  1. Division of Trauma and Surgical Critical Care, Department of Surgery, Vanderbilt University Medical Center, 1211 21st Ave, 404 Medical Arts Building, Nashville, TN, 37212, USA

    Bradley M. Dennis M.D. & Addison K. May M.D.

  2. Department of Radiology and Radiologic Sciences, Vanderbilt University Medical Center, 1161 21st Ave South, MCN CCC 1121, Nashville, TN, 37232, USA

    Geoffrey E. Wile M.D.

Authors
  1. Bradley M. Dennis M.D.
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  2. Geoffrey E. Wile M.D.
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  3. Addison K. May M.D.
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Corresponding author

Correspondence to Addison K. May M.D. .

Editor information

Editors and Affiliations

  1. Department of Surgery, Weill Cornell Medical College, New York, New York, USA

    Soumitra R. Eachempati

  2. Department of Surgery, Indiana University Acute Care Surgery, Indiana University Health Methodist Hospital, Indianapolis, Indiana, USA

    R. Lawrence Reed, II

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Dennis, B.M., Wile, G.E., May, A.K. (2015). The Diagnosis of Acute Cholecystitis. In: Eachempati, S., Reed, II, R. (eds) Acute Cholecystitis. Springer, Cham. https://doi.org/10.1007/978-3-319-14824-3_3

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  • DOI: https://doi.org/10.1007/978-3-319-14824-3_3

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-14823-6

  • Online ISBN: 978-3-319-14824-3

  • eBook Packages: MedicineMedicine (R0)

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