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©2013 UpToDate ® Print Email Acute cholecystitis with pericholecystic fluid seen on ultrasound (A) Longitudinal view of the gallbladder showing small shadowing stones in the dependent part of the gallbladder (green arrow). The ultrasound also shows a thickened wall in both the longitudinal projection (white arrow) and transverse projection (B). (B) A small amount of pericholecystic fluid is noted (yellow arrow). (C) The Doppler study shows an increase in blood flow to the wall (red arrow) reminiscent of the hyperemia of an inflammatory process. These findings are consistent with acute calculous cholecystitis.