Abdominal ultrasonography | Enlarged gallbladder size | First choice |
| Gallbladder wall thickening (>4mm) Incarcerated gallstone(s) Intraluminal debris echoes Pericholecystic fluid collection or abscess Positive “sonographic” Murphy sign Sonolucent “double wall sign” | Moderate sensitivity (88%90%) and specificity (80%) [63, 122-124] |
Hepatobiliary scintigraphy (technetium iminodiacetic | Compound given intravenously and excreted by the liver Test is positive if the gallbladder is not visualized (i.e., cystic | Highest sensitivity and specificity (≈90-95%) [123] |
acid or hydroxyiminodiacetic acid) | duct obstruction due to edema by acute cholecystitis) [63] | Not easily available |
Computed Tomography (CT) | Gallbladder wall edema | High sensitivity 94% |
| Pericholecystic fluid Other complications [125] | Low specificity 59% [123, 126] |
Magnetic Resonance | Gallstones are likely passed in the common bile duct [127] | Moderate accuracy [123] |
Cholangio-Pancreatography | | Not easily available |
(MRCP) | | Under evaluation |