[The perforated gallbladder in sonography].

The most dangerous complication in cholelithiasis is the perforation of the gallbladder wall. Ultrasound examination of patients with this disease is an easy technique for diagnosis. Four cases of sonographically detected perforation of the gallbladder are reported. Several distinctive sonographic diagnostic patterns depending on the side of perforation have evolved and are described. Suspicion of gallbladder perforation should be considered particularly in elderly patients with cholelithiasis and suddenly evolving pain in the right upper quadrant.