The acute abdomen is a medical term used to describe a patient who presents with sudden onset of severe abdominal pain sometimes accompanied by nausea, vomiting, diarrhea, abdominal distension, and even hypotension or shock.
Ultrasound is a well-established imaging modality for evaluating the abdomen, as it is noninvasive, portable, readily obtainable, relatively inexpensive, and without the risks of ionizing radiation or iodinated intravenous contrast. In addition, ultrasound has extremely high diagnostic accuracy in many clinical scenarios equivalent or even superior to CT .
The biliary tract
The most common cause of acute right upper quadrant (RUQ) pain in adults is acute cholecystitis. Ultrasound largely has replaced scintigraphy (HIDA scan) as the initial imaging modality of choice for evaluating patients with clinical suspicion of acute cholecystitis,
Furthermore, ultrasound has the additional advantages of being able to demonstrate potential complications of acute cholecystitis, such as perforation and gangrene, and the potential to identify nonbiliary causes of RUQ pain.
The two most important diagnostic criteria for the diagnosis of acute cholecystitis on ultrasound examination are the presence of gallstones and a positive sonographic Murphy's sign. In combination, these two findings have been shown by Ralls and colleagues to have a positive predictive value of 92% .
ultrasound images acute Cholecystititis