Diagnosis of gallbladder perforation by ultrasound

PURPOSE: The aim of this study was to identify possible pitfalls in the sonographic evaluation of perforated gallbladders.

METHODS: This is a retrospective analysis of sonograms of 11 patients diagnosed by surgery or pathology with perforated gallbladder. Sonograms were evaluated for multiple sonographic features.

RESULTS: Only three patients (27%) were diagnosed correctly with gallbladder perforation by ultrasonography prior to surgery. Gangrenous cholecystitis was reported in 10 cases (90%). Visualization of a wall defect was demonstrated in only five cases (45%) and was associated with a focal echogenic soft-tissue mass.

CONCLUSION: Missed perforations by ultrasound may partially result from technical inadequacies.