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Ultrasonic Imaging of Pericholecystic Inflammation

Michael Crade, MD; Kenneth J. W. Taylor, MD, PhD; Arthur T. Rosenfield, MD; James W. Walsh, MD
JAMA. 1980;244(7):708-709. doi:10.1001/jama.1980.03310070058036.
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ALTHOUGH the oral cholecystogram has been found to be an extremely reliable method of diagnosing cholecystitis,1,2 it is unable to document the presence or extent of pericholecystic inflammation. Similar in accuracy for diagnosing gallstones,3,4 ultrasound in addition can document the degree of inflammatory spread prior to surgery.5 The following cases illustrate this application.

Report of Cases 

Case 1.—  An 85-year-old man had a four-day history of abdominal pain, temperature elevation to 38.8 °C, and a WBC count of 19,500/cu mm. Ultrasound examination showed a stone within the gallbladder adjacent to a debris-filled abscess cavity (Fig 1). At surgery, 150 mL of pus was drained and the perforated gallbladder removed.

Case 2.—  Presenting with fever, a three-week history of jaundice, and a WBC count of 21,000/cu mm, a 50-year-old woman underwent an ultrasound examination for a palpated right upper abdominal mass. Findings were consistent with an empyema of the


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