Intravenous cholecystography is a reliable method in the diagnosis of acute cholecystitis

To evaluate the reliability of intravenous cholecystography in the diagnosis of acute cholecystitis, 186 consecutive patients with a clinical suspicion of acute cholecystitis were investigated. The contrast medium was administered as an intravenous infusion. The gall-bladder was not visualized in 110 patients (59%), suggesting acute cholecystitis. In 105 of these patients acute cholecystitis was confirmed at operation, or by a characteristic clinical course and/or oral cholecystography done later. There were 5 false positives; four of these patients were operated on, and proved to have other serious disease of the biliary tract. Filling of the gall-bladder was obtained in 76 cases (41%). One of these patients developed acute cholecystitis with perforation of the gall-bladder, diagnosed at laparotomy. In most other patients with filling of the gall-bladder diagnoses other than acute cholecystitis were verified. Intravenous cholecystography has proved highly reliable in the diagnosis of acute cholecystitis, and can contribute to reducing the incidence of misdiagnosis.