[Ultrasonic semeiotics and diagnosis of acute cholecystitis]

From analysis of the results of ultrasonic examination in 1,428 patients with acute cholecystitis the authors determined the semeiotics of various forms and complications of the disease. The most common ultrasonic sign of acute cholecystitis is a triad of symptoms: enlarged gallbladder, thickened walls, and fixed hyperchostructures with an acoustic shadow in the projection of the neck of the gallbladder. Ultrasonic examination allows the presence of destructive cholecystitis to be detected with high precision on basis of the sign of a double gallbladder contour. Complications like pericystic infiltration, pericystic abscess with or without perforation, empyema of the gallbladder, acute pancreatitis, and choledocholithiasis can also be recognized in patients with acute cholecystitis by ultrasonic examination. Comparison of the data of ultrasonic examination with those obtained in laparoscopy or operation showed that the diagnosis coincided in 98.9% of cases.