GIÁ TRỊ CỦA CẮT LỚP VI TÍNH TRONG CHẨN ĐOÁN VIÊM TÚI MẬT HOẠI TỬ TẠI CẦN THƠ NĂM 2023 - 2025

Abstract

  Background: Gangrenous cholecystitis is one of the complications of acute cholecystitis. Delayed diagnosis and intervention in cases of gangrenous cholecystitis can lead to gallbladder perforation, sepsis, and septic shock, which pose significant life-threatening risks to patients. Computed tomography plays a crucial role in assessing the condition of the gallbladder and surrounding organs, thereby facilitating accurate diagnosis and management strategies for gangrenous cholecystitis.Objectives: 1. To describe the computed tomography imaging characteristics of acute cholecystitis, 2. To determine the diagnostic value of computed tomography in gangrenous cholecystitis. Materials and methods: A cross-sectional descriptive study was conducted on 40 patients diagnosed with acute cholecystitis who underwent computed tomography imaging prior to surgery within 48 hours, from July 2023 to January 2025. Results: The computed tomography imaging features of acute cholecystitis and gangrenous cholecystitis, showed statistically significant differences in several parameters: gallbladder distention greater than 4cm, decreased mural enhancement, mural striation, intraluminal membranes, pericholecystic stranding, gallbladder perforation and pericholecystic abscess. Gallbladder distention greater than 4cm, decreased mural enhancement, mural striation, intraluminal membranes had sensitivity and specificity of 78.6%, 78.6%, 50%, 42.8%, and 61.5%, 92.3%, 88.5%, 96.2%, respectively. The presence of gas within the gallbladder lumen, gallbladder perforation, and pericholecystic abscess were signs with 100% specificity and positive predictive value in the diagnosis of gangrenous cholecystitis. Conclusions: Computed tomography  is a valuable imaging modality with a significant role in the diagnosis of gangrenous cholecystitis.