Diagnosis of gallbladder perforation by ultrasound

Shapira-Rootman, Mika; Mahamid, Ahmad; Reindorp, Nadir; Nachtigal, Alicia; Zeina, Abdel-Rauf

doi:10.1016/j.clinimag.2015.05.008

Cited by 14 publications

(16 citation statements)

References 13 publications

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“…Nonspecific clinical signs result in a late diagnosis with a 5-year survival rate of 5 % [464]. Differentiation between benign and malignant gallbladder tumors cannot be made by hyperenhancement during the arterial phase as gallbladder cancers (85 %) and benign gallbladder diseases (70 %) both show hyperenhancement [452,455]. The CEUS features of washout within 35 s after UCA administration, the destruction of gallbladder wall integrity and infiltration of the adjacent liver tissue are highly suggestive features of malignancy and highly suggestive of gallbladder cancer [441,445].…”

Section: Adenocarcinoma Of the Wallmentioning

confidence: 99%

The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version)

et al. 2018

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Section: Adenocarcinoma Of the Wallmentioning

confidence: 99%

The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version)

et al. 2018

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“…Ultrasound has a low specificity for diagnosing gallbladder perforation. Only 20%-30% of cases are diagnosed correctly prior to surgery [13-14]. CT scan of the abdomen proved superior to ultrasound in detecting gallbladder perforation, pericholecystic fluid, streaky omentum, or mesentery [15].…”

Section: Discussionmentioning

confidence: 99%

Gallbladder Perforation Secondary to Enteric Fever: An Interesting Case of Acute Abdomen

Malik

Mahmood

Din

et al. 2019

Cureus

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Enteric fever is a common infectious disease, especially in countries with poor sanitation and in the tropics. It is caused mainly by Salmonella typhi and accounts for nearly 27 million cases worldwide and 200,000 deaths annually. Enteric fever involves the reticuloendothelial system such as bone marrow, spleen, and liver. As it mostly involves the Peyer’s patches of the terminal ileum, enteric perforation occurs commonly. However, gallbladder perforation can also occur, though not very often. Ultrasound as well as computerized tomography (CT) abdomen and pelvis lack specificity for detecting gallbladder perforations in enteric fever. Diagnosis is usually confirmed intraoperatively when the gallbladder is visualized and perforation is seen. Gallbladder perforation is usually seen in acute cholecystitis when the gallbladder becomes necrotic and gangrenous. In acalculous cholecystitis, perforation is rare. Enteric fever is one of the rarest causes of acalculous cholecystitis, leading to perforation. Here, we present the case of a 20-year-old man who presented with fever for 10 days along with loose stools, vomiting, and acute abdomen. Labs showed leukopenia, positive Typhidot test but X-ray erect abdomen and ultrasound abdomen and pelvis were nonspecific. Only after resuscitation and exploration of the abdomen was it found that the gallbladder had multiple perforations. The patient was improved after eight days of postoperative intravenous antibiotics. This is a unique and rare presentation of such a common infectious disease.

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“…It has been reported that hyperenhancement in the arterial phase was present in 84.8% of carcinomas and in 70.2% of benign lesions (92.2% cholesterol polyps, 77.8% adenomas and 85.5% chronic cholecystitis) [10,28,30]. According to the most recent published EF-SUMB guideline and recommendations for the clinical practice of CEUS, differentiation between benign and malignant gallbladder tumors cannot be made by hyperenhancement during the arterial phase as gallbladder cancers (85%) and benign gallbladder diseases (70%), both showing hyper-enhancement [17,18,31,32].…”

Section: Discussionmentioning

confidence: 99%

Differential diagnosis of gallbladder ascariasis debris: the added value of contrast enhanced ultrasound with high frequency transducer

et al. 2018

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Ascariasis debris of the gallbladder is a very rare incidental or symptomatic presentation. Ascaris debris has a pseudotumorous appearance and may be confused with neoplasia. The aim of the current retrospective study is to investigate the value of contrast enhanced ultrasound (CEUS) for the differential diagnosis of ascariasis debris and neoplasia of the gallbladder.Material and methods: Conventional B-mode ultrasound (BMUS) and CEUS were performed for solitary echo-rich gallbladder lesions. Analysis of the CEUS enhancement pattern of the lesions was conducted according to the current EFSUMB guidelines. Two radiologists assessed the CEUS enhancement patterns in consensus. The final gold standard was surgery with histological examination or imaging follow-up.Results: A total of 9 patients with final diagnoses of gallbladder ascariasis debris were included. As a control group 26 solitary hyperechoic gallbladder lesions without shadowing were included as a control group. The typical zigzag morphology with multiple echogenic parallel lines without shadow were detected inside the lumen of the gallbladder in 6 patients. After injection of 2.4 ml ultrasound contrast agents, all hyperechoic gallbladder ascariasis debris lesions showed no enhancement. All patients in the control group with similar BMUS morphology showed contrast enhancement.Conclusions: Real time visualization of contrast enhancement without radiation exposure is one of the main advantages of CEUS over other diagnostic modalities to differentiate ascariasis debris in the gallbladder from enhancing neoplasia. Thus, surgery and other interventions and their complications could be avoided.

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Diagnosis of gallbladder perforation by ultrasound

Cited by 14 publications

References 13 publications

The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version)

The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version)

Gallbladder Perforation Secondary to Enteric Fever: An Interesting Case of Acute Abdomen

Differential diagnosis of gallbladder ascariasis debris: the added value of contrast enhanced ultrasound with high frequency transducer

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