Ultrasonography in the diagnosis of acute cholecystitis

Eighty-two patients with right upper quadrant pain and a clinical suggestion of acute cholecystitis had their gallbladder and biliary ducts ultrasonographically examined in the period immediately following admission to the hospital. Biliary calculi or signs of cholecystitis, or both, were found in 65 per cent of the cases at ultrasound examination. An additional 10 per cent had pathologic changes unrelated to the biliary tract. In 44 of 48 cases the presence of calculi or inflammation could be confirmed at surgery, autopsy or endoscopic retrograde cholangiopancreaticography. Only one patient with a normal ultrasound examination was later found to have a small calculus in a common bile duct of normal caliber.