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.
Keywords: Cholecystitis; Gallbladder; Gangrenous cholecystitis; Perforation; Ultrasound.
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