Abstract: Objective The aim of this study was to summarize the ultrasonographic features in patients with acute purulent cholecystitis (APC). Methods 50 patients with simple cholecystitis (SC) and 41 patients with APC were encountered in our hospital between April 2019 and April 2021, and all received sonography, and laparoscopic cholecystectomy. The diagnosis was proven by post-operational histopathological examination. Results The positive rates of poor bile acoustic transmission, gallbladder enlargement, thickened or rough gallbladder wall and positive Murphy sign in patients with APC were 85.4%, 92.7%, 82.9% and 90.2%, all significantly higher than 52.0%, 60.0%, 62.0% and 28.0%, respectively (P＜0.05) in patients with SC; out of 41 patients with APC, the color ultrasonographic examination misdiagnosed as cholestasis in 1 case (2.4%), as simple gallstones in one case(2.4%), and as SC in three cases(7.3%); at presentation, the white blood cell counts in patients with APC was (15.1±3.5)×10⁹/L, significantly higher than [(9.8±4.9)×10⁹/L, P＜0.05], total serum bilirubin level was (25.3±2.7)μmol/L, significantly higher than [17.1±3.1μmol/L, P＜0.05], and serum AST level was (97.1±5.6)U/L, significantly higher than [(36.7±4.7)U/L, P＜0.05] in patients with SC; after surgery, serum AST level was (50.3±4.3)U/L, still significantly higher than [(29.8±4.6)U/L, P＜0.05] in patients with SC. Conclusion Doppler ultrasonography could evaluate gallbladder morphology, gallbladder wall thickness, bile acoustic transmission and Murphy sign in patients with APC, which could provide a reliable imaging feature for the diagnosis of patients with acute purulent cholecystitis.

Key words: Acute purulent cholecystitis, Color Doppler ultrasound, Laparoscopic cholecystectomy, Diagnosis