ACUTE DISEASES OF THE GALLBLADDER AND BILIARY DUCTS

Approximately 10% to 15% of adults have gallstones, resulting in more than 600,000 cholecystectomies being performed annually in the United States.(35) It is not surprising, therefore, that biliary disease is a major consideration in the patient with acute abdominal pain. The int ernist, the surgeon, and the radiologist all play important roles in t he assessment of the patient with pain of suspected biliary origin. Cl inical differentiation of colic of gallbladder origin versus that of b ile duct origin can be difficult for even the most astute clinician. A lthough there is no substitute for skillful physical diagnosis, the ra diologist is often the central player in the evaluation of acute bilia ry disease. This article focuses on three specific areas of importance to the radiologist: (1) the diagnostic approach to acute biliary dise ase; (2) imaging of specific clinical entities; and (3) the relationsh ip between imaging findings and the use of new therapeutic modalities.