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Forty cases of acute cholecystitis, surgically and pathologically confirmed, were investigated with ultrasound. Echographic diagnosis was possible in 34 patients (85%): special emphasis was laid on wall thickening (90% of cases, with a mean wall thickness of 8.08 mm), evidence of an echofree layer within the wall (67.5% of patients) and a lumen greater than 4 cm with thick walls. Associated cholelithiasis was demonstrated in 28 of these patients. In five more patients specific wall signs were absent and cholelithiasis was the only detectable sign of the disease. In only one patient was there no echographic sign of acute cholecystitis.
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