The role of upper abdominal ultrasonography in suspected acute cholecystitis

Ultrasonic investigation of the upper abdomen was performed as an initial imaging procedure in 117 consecutive patients regarded on clinical examination as probably suffering from acute cholecystitis. All patients were studied within 72 h and the majority within 48 h of admission. All were followed up for a minimum of 12 months and the ultimate clinical diagnosis recorded and compared with the initial ultrasonic diagnosis. Despite the clinical suspicion at referral, only about half were ultimately found to have biliary tract or closely related pathology. In a further 10% totally unexpected and unrelated causes for the symptoms were detected. 87% of gallstones were detected on the initial ultrasonic examination, which compares well with previously reported series. In all cases where there was a right upper quadrant mass at presentation, the organ from which this arose was demonstrated. The results of this initial study indicate that upper abdominal ultrasonic examination is a valuable inital screening procedure in patients presenting with acute right upper abdominal symptoms.