Journal of Ultrasound in Medicine, Vol 8, Issue 9 499-506, Copyright © 1989 by American Institute of Ultrasound in Medicine
Morphologic and motility changes of the gallbladder in response to acute liver injury. A prospective real-time sonographic study in 255 patients with acute viral hepatitis
A. Giorgio, G. Francica, P. Amoroso, P. Fico, G. de Stefano, P. Pierri, G. Lettieri, T. Aloisio, L. Finelli and G. Pierri
Ospedale Specializzato per Malattie Infetive D. Cotugno, 5a Divisione, Napoli, Italy.
In 255 patients with acute viral hepatitis and in 50 healthy controls, wall
thickness, volume, and percentage of maximal contraction of the gallbladder
were prospectively evaluated using real-time ultrasonography. A hypotonic,
hypokinetic gallbladder was shown in 58.4% of the cases, expressed by
normal parietal thickness, larger volume, and lower response to fat
stimulation than the controls. In the remaining patients, wall thickening,
decreased volume, and reduced contraction were compatible with a hypertonic
gallbladder. Because the latter pattern was never observed in patients with
disease onset dating back more than 9 days, it is conceivable that
gallbladder hypertonicity in the early phase of the illness is followed by
depression of tone and motor activity. However, such sonographic features
turned out to be short-lived and reversible as they disappeared in all
patients within 3 weeks of the first ultrasound examination. Moreover, none
of the sonographic abnormalities correlated with either biochemical indices
of acute disease or the patients' long-term outcomes.
