Purpose The aim of this study was to evaluate whether the comet tail artifact on ultrasonography can be used to reliably diagnose benign gallbladder diseases. Methods This retrospective study reviewed the clinical findings, imaging findings, preoperative ultrasonographic diagnoses, and pathological diagnoses of 150 patients with comet tail artifacts who underwent laparoscopic cholecystectomy with pathologic confirmation. The extent of the involved lesion was classified as localized or diffuse, depending on the degree of involvement and the anatomical section of the gallbladder that was involved. This study evaluated the differences in clinical and imaging findings among pathologic diagnoses. Results All gallbladder lesions exhibiting the comet tail artifact on ultrasound examination were confirmed as benign gallbladder diseases after cholecystectomy, including 71 cases of adenomyomatosis (47.3%), 74 cases of chronic cholecystitis (49.3%), two cases of xanthogranulomatous cholecystitis (1.3%), and three cases of cholesterolosis (2.0%); there were two cases of coexistent chronic cholecystitis and low-grade dysplasia. There were no statistically significant differences in any of the clinical and ultrasonographic findings, with the exception of gallstones (P=0.007), among the four diseases. There were no significant differences in the average length, thickness, or number of comet tail artifacts among the four diagnoses. No malignancies were detected in any of the 150 thickened gallbladder lesions. Conclusion The ultrasonographic finding of the comet tail artifact in patients with thickened gallbladder lesions is associated with the presence of benign gallbladder diseases, and can be considered a reliable sign of benign gallbladder disease.

Purpose:To evaluate ultrasonographic accuracy in the differentiation of a bezoar from feces in a small bowel obstruction showing feces-like material just proximal to the transitional zone in abdominal computed tomography (CT).Methods:This study included 14 patients who showed feces-like material just proximal to the transitional zone, among 302 patients diagnosed with small bowel obstruction on abdominal CT. The diagnostic signs of a bezoar on ultrasonography included an arc-like surfaced intraluminal mass, posterior acoustic shadow and twinkling artifacts. The diagnostic performance of ultrasonography in each patient was compared with a final diagnosis that was surgically or clinically made.Results:Among the 14 patients, seven were ultrasonographically diagnosed as having a bezoar, and five of the seven were surgically diagnosed as having a phytobezoar. The remaining two of the seven showed complete symptomatic improvement before surgery. The other seven patients were ultrasonographically diagnosed as not having a bezoar. Among them, six patients were conservatively treated with symptomatic improvement, suggesting the absence of a bezoar. The remaining one patient was confirmed not to have a bezoar during adhesiolysis. In all patients, the ultrasonographic diagnosis agreed with the clinically confirmed diagnosis.Conclusion:Ultrasonography might be an accurate method for the differential diagnosis of feces-like material just proximal to the transitional zone in abdominal CT. It can help radiologists to quickly and easily diagnose a bezoar.

Uterine cervical cancer is one of the most common malignancies of the female genital tract. Most recurrent cases of uterine cervical cancer are diagnosed within two years after primary treatment, and late recurrence after a disease-free interval of more than five years is rare. In addition, peritoneal metastases usually present as multifocal discrete nodules in the peritoneal cavity with nodular or diffuse peritoneal thickening. Herein, we report an extremely rare case of late recurrent cervical cancer peritoneal metastasis with an unusual manifestation of a large, solitary necrotic mass in the right subphrenic space on contrast-enhanced CT.