What is the first-line diagnostic imaging modality for a patient presenting with suspected acute cholecystitis?

Answer and explanation

Correct answer: B. Transabdominal right upper quadrant ultrasound

  1. Step 1: Right upper quadrant ultrasound is the initial imaging modality of choice due to high sensitivity for gallstones, gallbladder wall thickening (> 3 mm), pericholecystic fluid, and the sonographic Murphy sign.
  2. Step 2: It is non-invasive, widely available, and does not require ionizing radiation.
Answer
Transabdominal right upper quadrant ultrasound.
Why not the others: 'Oral contrast abdominal CT scan' is less sensitive for gallstones and exposes the patient to radiation; 'Endoscopic retrograde cholangiopancreatography (ERCP)' is an invasive therapeutic procedure for ductal stones, not diagnostic cholecystitis; 'Plain abdominal radiograph (KUB)' detects only the 15% of gallstones that are radiopaque.

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