From the Guidelines
Pericholecystic fluid on an ultrasound is a significant indicator of acute cholecystitis, suggesting gallbladder wall irritation and inflammation, often due to gallstone obstruction, and typically requires prompt medical attention with antibiotics and possible surgical removal of the gallbladder. This finding is characterized by the presence of fluid surrounding the gallbladder, appearing as a dark or anechoic area on ultrasound images, and is often accompanied by other signs such as gallbladder wall thickening, gallstones, and a positive sonographic Murphy's sign 1. The presence of pericholecystic fluid is a critical diagnostic criterion, as it indicates increased blood flow and leakage of fluid from blood vessels into the surrounding tissues due to inflammation, and its detection is crucial for preventing complications such as perforation or abscess formation 1. Key considerations in the management of acute cholecystitis include the use of ultrasonography as the first imaging technique, the administration of antimicrobial therapy, and the potential need for cholecystectomy, with the timing of surgery depending on the severity of the condition and the patient's overall health status 1. In terms of specific management strategies, early laparoscopic cholecystectomy is generally recommended for patients with acute cholecystitis, although the decision to proceed with surgery should be based on individual patient factors, including the presence of complications such as gangrene or perforation 1. Overall, the detection of pericholecystic fluid on ultrasound is a critical finding that requires prompt attention and appropriate management to prevent serious complications and improve patient outcomes.
From the Research
Definition of Pericholecystic Fluid
Pericholecystic fluid refers to the accumulation of fluid around the gallbladder, which can be detected through ultrasound imaging.
Ultrasound Findings
The ultrasound findings of pericholecystic fluid can vary, ranging from a well-defined band of low-level echoes around the gallbladder to multiple, poorly defined hypoechoic masses surrounding an irregular, indistinct gallbladder outline 2.
Association with Acute Cholecystitis
Pericholecystic fluid is often associated with acute cholecystitis, a serious complication of gallbladder inflammation that can lead to gallbladder perforation and pericholecystic abscess formation 2, 3, 4.
Diagnostic Accuracy
The accuracy of point-of-care ultrasound in diagnosing acute cholecystitis, including the detection of pericholecystic fluid, has been studied, with sensitivity and specificity rates ranging from 0.33 to 0.4 and 0.94 to 0.99, respectively 3.
Key Features
The key features of pericholecystic fluid on ultrasound include: