Presentation
RUQ pain and fever
Patient Data
Age: 50 years
Gender: Female
From the case:
Acute calcular cholecystitis
Transverse

Gallbladder distension more than 10 cm, surrounding edema and streak of free fluid, gallstone obstructing the neck of GB, moderate amount of sludge, wall thickening more than 5mm, sonographic Murphy's sign positive. Features of acute cholecystitis.
Case Discussion
The most sensitive ultrasound finding in acute cholecystitis is the presence of cholelithiasis in combination with the sonographic Murphy sign. Both gallbladder wall thickening (>3 mm) and pericholecystic fluid are secondary findings.