Acute cholecystitis: Do sonographic findings and WBC count predict gangrenous changes?

Sharlene A. Teefey, Nirvikar Dahiya, William D. Middleton, Sanjeev Bajaj, Neha Dahiya, Lourdes Ylagan, Charles F. Hildebolt

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

OBJECTIVE. The purpose of our study was to determine, first, if gallbladder wall striations in patients with sonographic findings suspicious for acute cholecystitis are associated with gangrenous changes and certain histologic features; and, second, if WBC count or other sonographic findings are associated with gangrenous cholecystitis. MATERIALS AND METHODS. Sixty-eight patients who underwent cholecystectomies within 48 hours of sonography comprised the study group. Sonograms and reports were reviewed for wall thickness, striations, Murphy sign, pericholecystic fluid, wall irregularity, intraluminal membranes, and luminal short-axis diameter. Medical records were reviewed for WBC count and pathology reports for the diagnosis. Histologic specimens were reviewed for pathologic changes. Statistical analyses tested for associations between nongangrenous and gangrenous cholecystitis and sonographic findings and for associations between wall striations and histologic features. RESULTS. Ten patients had gangrenous cholecystitis and 57, nongangrenous cholecystitis. One had cholesterolosis. Thirty patients had wall striations: 60% had gangrenous and 42% nongangrenous cholecystitis. There was no association with the pathology diagnosis (p = 0.32). There was no association between any histologic feature and wall striations (p ≥ 0.19). A Murphy sign was reported in 70% of patients with gangrenous cholecystitis and in 82% with nongangrenous cholecystitis; there was no association with the pathology diagnosis (p = 0.39). Wall thickness and WBC count were greater in patients with gangrenous cholecystitis than in those with nongangrenous cholecystitis (p ≤ 0.04). CONCLUSION. Gallbladder wall thickening and increased WBC counts were associated with gangrenous cholecystitis; however, there was considerable overlap between the two groups. Wall striations and a negative Murphy sign were not associated with gangrenous cholecystitis.

Original languageEnglish (US)
Pages (from-to)363-369
Number of pages7
JournalAmerican Journal of Roentgenology
Volume200
Issue number2
DOIs
StatePublished - Feb 1 2013

Keywords

  • Gallbladder
  • Gangrenous cholecystitis
  • Striated wall thickening
  • Ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'Acute cholecystitis: Do sonographic findings and WBC count predict gangrenous changes?'. Together they form a unique fingerprint.

  • Cite this

    Teefey, S. A., Dahiya, N., Middleton, W. D., Bajaj, S., Dahiya, N., Ylagan, L., & Hildebolt, C. F. (2013). Acute cholecystitis: Do sonographic findings and WBC count predict gangrenous changes? American Journal of Roentgenology, 200(2), 363-369. https://doi.org/10.2214/AJR.12.8956