Acute cholecystitis

• Most sensitive finding is combination of gallstones and positive sonographic Murphy sign
  • Not necessarily the finding of the impacted stone
• With gallbladder enlargement, short-axis dimension is more important than the long-axis dimension
• Pericholecystic fluid usually indicates more advanced cholecystitis
  • Important to differentiate from wall edema. Wall edema more common between the gallbladder and liver in loose areolar tissue