The initial imaging test of choice for suspected acute cholecystitis?

The initial imaging test of choice for suspected acute cholecystitis?

• A. Right upper quadrant ultrasound
• B. CT abdomen
• C. HIDA scan
• D. MRCP

Answer: (A)

Right upper quadrant ultrasound is the preferred initial imaging when acute cholecystitis is suspected because it is quick, noninvasive, and excels at assessing gallbladder pathology. It can detect gallstones and inflammation-related findings such as gallbladder wall thickening, gallbladder distention, and pericholecystic fluid, and it can demonstrate the sonographic Murphy sign. Together, these features strongly support the diagnosis and help guide urgent management. If ultrasound is nondiagnostic, a HIDA scan is the next step to evaluate cystic duct patency by seeing whether the gallbladder fills; nonvisualization on HIDA is highly specific for acute cholecystitis. CT is less sensitive for gallstones and MRCP is more detiled biliary imaging used when ductal issues are a concern, not as the first test.

Right upper quadrant ultrasound is the preferred initial imaging when acute cholecystitis is suspected because it is quick, noninvasive, and excels at assessing gallbladder pathology. It can detect gallstones and inflammation-related findings such as gallbladder wall thickening, gallbladder distention, and pericholecystic fluid, and it can demonstrate the sonographic Murphy sign. Together, these features strongly support the diagnosis and help guide urgent management. If ultrasound is nondiagnostic, a HIDA scan is the next step to evaluate cystic duct patency by seeing whether the gallbladder fills; nonvisualization on HIDA is highly specific for acute cholecystitis. CT is less sensitive for gallstones and MRCP is more detiled biliary imaging used when ductal issues are a concern, not as the first test.