To the Editor.—
The recent article by Chandnani et al (237:996, 1977), in which hydrops of the gallbladder was diagnosed using measurements obtained by sonography, is misleading on several points. Since there is a wide range in size of the gallbladder in normal patients, measurements per se do not allow a reliable diagnosis of pathological enlargement of the gallbladder. Their patient's gallbladder did have a rounded "tense" configuration that is suggestive but not diagnostic of cystic duct obstruction.The measurement data from Goldberg et al1 and Redman and Reuter2 cited by the authors do not provide a valid criteria in diagnosing pathological enlargement of the gallbladder. The study of Goldberg et al1 was designed to document the reliability of measurements of the gallbladder made by ultrasound; thus, a "mean" gallbladder width of 3.4 cm in their population of patients has little importance. Redman and Reuter's2 study
Conrad MR. Ultrasound and Diagnosis of Hydrops of the Gallbladder. JAMA. 1977;238(7):581–582. doi:10.1001/jama.1977.03280070021011
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