摘要
膽囊蓄膿意指行膽囊切除術時，膽囊腔內有膿液的存在。此類患者若未及早做外科手術治療，併發症及因感染引起的死亡率有顯著的提高。21例開刀證實為膽囊蓄膿的患者，其主要超音波發現為：膽囊內有瀰漫性及I或散在性回音(82%)，其他次要的發現如膽囊壁呈增厚現象(95%)尤其膽囊壁有間斷甚至清晰呈示出破裂孔者(54%)，陽性Murphy's徵(80%)，膽囊腔前後徑增大(72%),膽結石(67%)，膽囊旁積液(48%)，漿膜下暈輪(48%)，總膽管擴張(30%)。臨床症狀常見右上腹痛(84%)，發燒(71%)，黃疸(48%)。一般實驗室檢查則以白血球增加平均16250/ml)及膽紅素增高（平均4.65 mg%）較為特殊。膽汁細菌培養則以大腸桿菌(E. co li)克雷萊氏肺炎桿菌(Kleb, pneumonia)常見，若有兩種以上的細菌存在較常見克雷萊氏菌搭配其他少見的革蘭氏陰性菌。由臨床症狀或實驗室數據並不易區分膽囊蓄膿或急性膽囊炎，如有效地應用超音波檢視膽囊本身及膽囊窩之變化，將有助於診斷膽囊蓄膿，從而使患者及早手術以減少其併發症。
並列摘要
Empyema of gall bladder (GBE) is referred to as an inflammatory process of the gall bladder (GB) with pus accumulation in the lumen identified during surgery. Early surgery is absolutely indicated in patients with GBE since a much higher motality will be found in cases with delayed surgical intervention, eithe due to sepsis or other complications. The snograms (US) of 21 patients having surgically proved GBE were reviewed. Important US findings included: Diffuse and/or discrete fine internal echoes inside the GB 982%), thickened GB wall (95%), interrupted GB wall echoes or distinct ruptured holes (54%), positive US Murphy's sign(80%),increased anteroposterior diameter of the GB (72%), presence of gall stone(s) (67%), pericholecystic fluid accumulation (48%) , and presence of subserosal halo (48%) CBD Dilatat:on (30). The laboratory findings included leukocytosis and elevated serum bilirubin (average: 16250/cmm and 4.65 mg% respectively). The most common bacteriors cultured from the bile were E. coli and K. pneumoniae. If more than one bacterior were found, it would be K. pneumonia and other relatively rare Grom (-) bacilli. It is not easy to differentitate between GBE and acute cholecystitis on the basis of clinical symptoms, signs, and laboratory data. Attentive applicaation of US in examining the GB and GB fossa is very helpful in diagnosing GBE and therefore preventing serious complication.