Ultrasonographic findinggs of 60 patients with histolo gically verified primary gallbladder carcinoma were analyzed with special emphasis in diagnostic difficulties and pitfalls, sonographic diagnosis was correct in 40 patients, thus the sensitivity was 66.7%. Sonography of 20 incorrectly diagnosed cases were interpretated as benign biliary disease in 15(complicated cholecysititis in 9, gallbladder or bile duct stone in 6) and malignant disease in 5 with incorrect diagnosis of primary site. Thickened wall type was the most frequent type of false negative cases. The causes of sonographic diagnostic difficulty or pitfalls were 1) poor criteria of benign vs malignant wall thickening because of frequent association of complicated cholecystitis in gallbladder carcinoma,2) Overlook of small gallbladder lesions in cases with common bile duct disease including stone.3) inadequate study or technical problem especially in cases of localized carcinoma involving the fundus, neck or anterior wall. Knowledge of these diagnostic pitfalls may result in more accurate diagnosis of gallbladder carcinoma.
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