Dynamics of Ultrasound Findings in Acute Cholecystitis
Abstract
Background: Abdominal ultrasound is the first-line imaging modality for diagnosing acute cholecystitis. While sonographic criteria for acute cholecystitis are well established, their temporal dynamics and correlation with disease severity remain poorly understood. This study aimed to explore the time course of ultrasound findings in acute cholecystitis. Methods: Between November 2017 and October 2018, patients admitted with acute cholecystitis fulfilling the Tokyo Guidelines were prospectively enrolled. All patients received standard care and underwent an initial abdominal ultrasound at admission. Daily follow-up scans were planned until cholecystectomy or discharge. Patients with at least two ultrasound exams were included in the final analysis. Parameters assessed included gallbladder wall thickness and volume, as well as mural and pericholecystic edema. All exams followed a standardized protocol and were performed by certified ultrasound specialists. Results: A total of 120 patients were enrolled. Of these, 88 underwent at least one ultrasound examination, and 37 received two or more scans and were included in the final analysis. Gallbladder wall edema was present in all but one case and remained stable over time. Mean gallbladder wall thickness and volume showed minimal changes, with a slight reduction in volume during the 1st days. Substantial intraindividual variability in gallbladder volume and wall thickness was observed, independent of disease severity. Conclusion: Sonographic criteria for acute cholecystitis remain stable over time, suggesting that the timing of ultrasound does not affect diagnostic accuracy. However, substantial individual variability limits their use for risk scoring or severity grading, highlighting the need for complementary diagnostic approaches.
Related
- Radiographic Findings Concerning for Gangrenous Cholecystitis in an Asymptomatic Elderly Patient: A Case for Conservative Management
- Development and Internal Validation of a Preoperative Risk Stratification Model for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis
- Association of Serum Ferritin and Cytokine Profile With Severity of Acute Cholecystitis in Patients Undergoing Laparoscopic Cholecystectomy
- Rapid Progression of Acute Acalculous Cholecystitis to Gangrenous Cholecystitis in an Initially Non-Critically Ill Patient: A Case Report.
- Acute Gangrenous Cholecystitis During Pregnancy: A Case Report.
BibTeX
@article{runfors2026dynamics,
title = {{Dynamics of Ultrasound Findings in Acute Cholecystitis}},
author = {Camilla Runfors and Martin Dahlberg and Anna Lindelius and Erik Jervaeus and Hans Järnbert-Pettersson and Anders Sondén},
journal = {Journal of Medical Ultrasound},
year = {2026},
month = jul,
doi = {10.4103/jmu.jmu-d-25-00038},
url = {https://doi.org/10.4103/jmu.jmu-d-25-00038},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Dynamics of Ultrasound Findings in Acute Cholecystitis
AU - Camilla Runfors
AU - Martin Dahlberg
AU - Anna Lindelius
AU - Erik Jervaeus
AU - Hans Järnbert-Pettersson
AU - Anders Sondén
PY - 2026
DA - 2026/07/01
JO - Journal of Medical Ultrasound
DO - 10.4103/jmu.jmu-d-25-00038
UR - https://doi.org/10.4103/jmu.jmu-d-25-00038
AB - Background: Abdominal ultrasound is the first-line imaging modality for diagnosing acute cholecystitis. While sonographic criteria for acute cholecystitis are well established, their temporal dynamics and correlation with disease severity remain poorly understood. This study aimed to explore the time course of ultrasound findings in acute cholecystitis. Methods: Between November 2017 and October 2018, patients admitted with acute cholecystitis fulfilling the Tokyo Guidelines were prospectively enrolled. All patients received standard care and underwent an initial abdominal ultrasound at admission. Daily follow-up scans were planned until cholecystectomy or discharge. Patients with at least two ultrasound exams were included in the final analysis. Parameters assessed included gallbladder wall thickness and volume, as well as mural and pericholecystic edema. All exams followed a standardized protocol and were performed by certified ultrasound specialists. Results: A total of 120 patients were enrolled. Of these, 88 underwent at least one ultrasound examination, and 37 received two or more scans and were included in the final analysis. Gallbladder wall edema was present in all but one case and remained stable over time. Mean gallbladder wall thickness and volume showed minimal changes, with a slight reduction in volume during the 1st days. Substantial intraindividual variability in gallbladder volume and wall thickness was observed, independent of disease severity. Conclusion: Sonographic criteria for acute cholecystitis remain stable over time, suggesting that the timing of ultrasound does not affect diagnostic accuracy. However, substantial individual variability limits their use for risk scoring or severity grading, highlighting the need for complementary diagnostic approaches.
SN - 0929-6441
SN - 2212-1552
ER -