Contrast-enhanced ultrasonography to diagnose gallbladder perforation

Area of Science:

• Medical Imaging
• Gastroenterology
• Diagnostic Ultrasound

Background:

• Gallbladder (GB) perforation with pericholecystic hepatic abscess is a severe complication of acute cholecystitis.
• Accurate and timely diagnosis is crucial for effective management.

Purpose of the Study:

• To evaluate the diagnostic performance of contrast-enhanced ultrasonography (CEUS) for gallbladder perforation.
• To assess CEUS in identifying associated pericholecystic hepatic abscesses.

Main Methods:

• Retrospective analysis of 6 patients with acute cholecystitis, GB perforation, and pericholecystic hepatic abscess.
• Comparison of conventional ultrasound (US) findings with CEUS imaging.
• Examination of GB contour, GB wall defects, and pericholecystic masses.

Main Results:

• Conventional US showed GB wall defects in 2 patients and obscured walls in 4.
• CEUS revealed hyperenhancement of the GB wall and a defect in all patients.
• CEUS demonstrated heterogeneous, honeycomb-like enhancement of pericholecystic masses, indicative of abscesses.

Conclusions:

• CEUS provides clear visualization of GB wall defects in patients with perforation.
• CEUS accurately identifies pericholecystic abscesses.
• CEUS is a valuable imaging modality for diagnosing GB perforation.