Ultrasonographic findings of gallbladder perforation

Journal of Korean Society of Medical Ultrasound 1994;13(1): 7-12.

ABSTRACT

Gallbladder perforation may require emergency operation. However, it is a difficult to differentiateclinically between gallbladder perforation and uncomplicated acute cholecystitis. Therefore, early diagnosis basedon ultrasonogram is important. We reviewed the ultrasound findings and sought new finding of 17 patients withgallbladder perforation confirmed by surgery (n=16) and percutaneous transhepatic cholecystomy(n=1) The commonfindings of gallbladder perforation were pericholecystic fluid collection(88.2%), cholelithiasis (70.6%), layeringof gallbladder wall (64.7%), thickened gallbladder wall(58.8%) and focal bulging of gallbladder wall(41.2%).Gallbladder wall defect was seen in two case. Cholecystoenteric fistula and intrahepatic abscess formation wereseen in one case each. All of the locations of focal bulging of gallbladder wall (n=7) and gallbladder wall defect(n=2) were confirmed as perforated sites of gallbladder at operation. In summary, focal bulging of gallbladderwall and gallbladder wall defect indicate perforated site of gallbladder.

Keywords: Gallbladder,perforation