Miyazaki et al developed an ultrasonographic risk score for patients acute cholecystitis. This can help identify patients with more severe disease. The authors are from Kyushu University Hospital in Fukuoka, Japan.
Parameters:
(1) gallbladder distention
(2) thickened gallbladder wall
(3) debris within the lumen of the gallbladder
(4) halo (sonolucent zone in the gallbladder wall)
(5) pericholecystic fluid
(6) intraluminal membrane
(7) round gallbladder
|
Parameter |
Finding |
Points |
|
gallbladder distention |
absent |
0 |
|
|
present |
4 |
|
thickened gallbladder wall |
absent |
0 |
|
|
present (>= 0.5 mm) |
1 |
|
debris within the lumen |
absent |
0 |
|
|
present |
3 |
|
halo |
absent |
0 |
|
|
present |
2 |
|
pericholecystic fluid |
absent |
0 |
|
|
present |
7 |
|
intraluminal membrane |
absent |
0 |
|
|
present |
4 |
|
round gallbladder |
absent |
0 |
|
|
present |
3 |
where:
• A distended gallbladder was >= 8 cm long and >= 4 cm in diameter.
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 24
• The higher the score the more severe the cholecystitis.
• The presence of a score >= 11 indicates a need for immediate surgery.
• Because an elderly patient is at greater risk for rupture of the gallbladder wall surgery should be considered even when the score is < 11.
Specialty: Infectious Diseases, Gastroenterology
