Acute cholecystitis is inflammation of the gallbladder
usually from impaction of a gallstone within the cystic or common bile duct .
Ultrasound is the preferred imaging method to confirm cholecystitis in the appropriate clinical setting .
CT findings of cholecystitis include : 1 . Cholelithiasis 2 . Gallbladder wall thickening 3 . Pericholecystic fluid . Complicated cases may reveal perforation or hepatic abscess formation .
Acute calculous cholecystitis:
Calculus obstructs the cystic duct
The trapped concentrated bile irritates the gallbladder wall, causing increased secretion, which in turn leads to distention and edema of the wall.
Rising intra luminal pressure compresses the vessels, resulting in thrombosis, ischemia, and subsequent necrosis and perforation of the wall.
Thickening of gallbladder wall Cholelithiasis .
Acute pancreatitis is most often secondary to alcohol abuse or gallstone impaction in the distal common bile duct .
Other causes include trauma, cryptogenic, tumor, infection, hyperlipidemia, and ERCP . CT Findings typical of pancreatitis include :
1 . An enlarged pancreas with infiltration of the surrounding fat 2 . Peripancreatic fluid collections can often be seen 3 . Pseudocysts, ( encapsulated fluid collections containing pancreatic secretions, are later complications of pancreatitis )
Notice the peripancreatic stranding ( bars ) as well as the fluid thickening of the interfascial space
A common complication of pancreatitis is the development of pancreatic necrosis .
Lack of gland enhancement following IV contrast administration is diagnostic . When over half the pancreas becomes necrosed, the mortality rate may reach as high as 30% .
Right lower quadrant pain, fever and leukocytosis are the classical clinical findings .
CT and US are being used more often to confirm clinical suspicions and reduce the number of unnecessary laporotomies .
General CT findings for acute appendicitis include : 1 . Dilated appendix greater than 6 mm or visualization of an appendicolith with an appendix of any size 2 . Peri - appendicial fat stranding
This image of an acute abdomen ( arrow ) displays periappendicial stranding and dilattion of its terminal portion .
For comparison, this image of a normal appendix can be visualized at the ileocecal junction . Also notethe fat ventralcontaining heria
Inflammation - Colitis
Colitis, or inflammation of the colon, is a frequent cause of abdominal pain .
Specific entities which produce inflammatory thickening of the colon include:-
Diverticulitis, inflammatory bowel disease, pseudomembranous colitis, and other bacterial infections ( i . e . typhlitis ).
This example of colitis shows thickening of the colon and pericolonic stranding typical of inflammation .
Thickening of sigmoid colon due to pseudomembranous colitis
A case of diverticulitis showing a thickened sigmoid colon and a diverticulum
Distal ureteral stone lead ing to right hyrdronephrosis in above image Ureteral junctional stone Renal Colic
Renal stone right sided hydronephrosis Renal Colic