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Background
Evaluation of the gallbladder in the setting of acute right upper quadrant pain is a common endeavor in many radiology departments. Therefore, patients presenting with clinical features suggesting acute cholecystitis should undergo imaging to confirm the diagnosis. Although ultrasound is the clear initial examination of choice for a patient with right upper quadrant pain, fever, leukocytosis, and a positive Murphy sign, this classic presentation may not be typical in daily practice. CT may be the initial study for either patients in the emergency department or admitted to the floor. Complications of acute cholecystitis have a characteristic CT appearance and include necrosis, perforation, abscess formation, intraluminal hemorrhage, and wall emphysema. In this exhibit, we will review imaging features of acute gall bladder pathologies, common complications, and their typical imaging features.

Educational Goals / Teaching Points
1. Incidence and prevalence of acute gall bladder pathology. 2. Review imaging features of complications of acute gall bladder pathologies, including multimodality case-based review of typical and challenging cases with pathological correlation. 3. Review of prognosis, management, and posttreatment imaging of acute gall bladder pathologies.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In this review, we will present cases of acute gall bladder pathologies on different imaging modalities including CT, ultrasound, MRI, and nuclear imaging. We will also present complications for cases after intervention, imaging techniques, and management plans.

Conclusion
Recognizing acute cholecystitis and its complications is important for every radiologist in reducing morbidity and mortality for associated serious complications.