Investigations

The key investigations in chronic cholecystitis are: (1)

• ultrasonography:
  • can show gallstones with or without thickening of the mucosa
• CT
  • the gallbladder itself may appear distended or contracted, however, pericholecystic inflammation and fluid collection are usually absent. (2) A distended gallbladder and increased enhancement of adjacent hepatic tissue go more in favour of acute cholecystitis, whereas hyperenhancement of the gallbladder wall is more commonly seen in the chronic disease. (3)
• endoscopy
  • to distinguish the differentials of gastritis and peptic ulceration

Reference:

1. Elwood DR. Cholecystitis. Surg Clin North Am. 2008;88(6):1241-52
2. Smith EA, Dillman JR, Elsayes KM, Menias CO, Bude RO. Cross-sectional imaging of acute and chronic gallbladder inflammatory disease. AJR Am J Roentgenol. 2009 Jan;192(1):188-96
3. Yeo DM, Jung SE. Differentiation of acute cholecystitis from chronic cholecystitis: Determination of useful multidetector computed tomography findings. Medicine (Baltimore). 2018 Aug;97(33):e11851