The Diagnostic Dilemma of Acute Cholecystitis in Heart Failure: A Review Based on Tokyo Criteria

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Eurasian Journal of Critical Care
Cilt: 7 Sayı: 3
The Diagnostic Dilemma of Acute Cholecystitis in Heart Failure: A Review Based on Tokyo Criteria

The Diagnostic Dilemma of Acute Cholecystitis in Heart Failure: A Review Based on Tokyo Criteria

Pages : 55-57

View : 25 | Download : 319

Publication Date : 2025-12-31

Article Type : Other Papers

Abstract :Diagnosing acute cholecystitis in patients with heart failure presents a significant clinical challenge due to overlapping symptoms, imaging findings, and inflammatory markers. The Tokyo Guidelines (TG18) provides a structured diagnostic framework based on clinical signs, imaging, and laboratory parameters. However, heart failure, particularly right-sided—factors such as hepatic congestion, peritoneal stretching, and systemic inflammation can mimic cholecystitis. Gallbladder wall thickening, a key imaging criterion, is often observed in heart failure due to venous congestion rather than true inflammation. Similarly, elevated inflammatory markers like CRP and leukocytosis can result from the systemic inflammatory milieu of heart failure, not infection. This overlap risks both misdiagnosis and inappropriate treatment. This review highlights the diagnostic dilemma and emphasizes the importance of a multidisciplinary approach, advanced imaging modalities, and dynamic monitoring. It also advocates for the development of integrated diagnostic tools tailored for this patient population. Accurate differentiation between true acute cholecystitis and heart failure-related changes is essential to avoid unnecessary interventions and optimize patient outcomes.
Keywords : Akut Kolesistit, Kalp Yetmezliği, Semptomlar

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