PAEA Surgery End Of Rotation (EOR) Practice Exam

What is the test of choice to diagnose cholecystitis?

1. X-ray

2. MRI

3. Ultrasound

4. CT scan

The correct answer is: Ultrasound

The preferred test for diagnosing cholecystitis is ultrasound, primarily due to its high sensitivity and specificity for detecting gallbladder inflammation. Ultrasound is a non-invasive imaging modality that is readily available, does not expose the patient to ionizing radiation, and can be performed quickly in an emergency setting. It allows for the visualization of gallstones, thickening of the gallbladder wall, and the presence of pericholecystic fluid, all of which are important indicators in the diagnosis of acute cholecystitis. Other imaging techniques, such as CT scans or MRIs, might be used in specific circumstances but are not the first line. While a CT scan is sensitive and can provide detailed images of the abdomen, it involves exposure to radiation and is typically reserved for cases where ultrasound is inconclusive or there is a need to evaluate other intra-abdominal issues. MRI is not commonly indicated for the diagnosis of cholecystitis due to higher costs, longer evaluation times, and limited availability in acute settings. X-ray has very limited utility in directly diagnosing cholecystitis, as gallstones are not always visible, and other findings are non-specific. Hence, ultrasound stands out as the most effective and practical choice