Takeshi HARA , Hidekazu ITOH , Kikukazu SAKATSUJI , Jun KAWAI , Hidenori NAKATA , Yukihiro YOKOTA , Shinya KAWAGUCHI, Yasuhito ISHIHARA, Hiroshi TOKUYAMA , Shingo NISHIOKA

Second Department of Internal Medicine, Wakayama Medical College

キーワード : Emphysematous cholecystitis , Ultrasound

Although emphysematous cholecystitis is a rare disease, it is a serious form of acute cholecystitis caused by gas-forming organisms. We have observed three patients with emphysematous cholecystitis, and evaluate a diagnostic efficiency for this disease of an ultrasound. An ultrasonic examination clearly showed gas situated in the gallbladder wall as a characteristic thick circular layer of strong echoes along the gallbladder wall in Case 1. Gas situated in the lumen of the gallbladder was shown as a broad band of strong echoes casting an acoustic shadow with multiple reflection in Case 2. In Case 3 an ultrasonic examination revealed a number of areas of particularly high reflectivity in the gallbladder lumen, which were thought to represent gas. We propose that an ultrasound examination is very useful for the diagnosis of emphysematous cholecystitis, but it should be noted that in order to show up in an ultrasound examination, several days are required for sufficient gas to accumulate.