Presentation
Severe right upper quadrant pain with sepsis and hypotension
Patient Data
Age: 65
Gender: Male
From the case:
Emphysematous cholecystitis with local perforation
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Too sick for oral and IV contrast - renal dysfunction due to dehydration
Gas within the wall of the gall bladder with an air/fluid level in the lumen. Note gas has tracked beyond the wall into the subhepatic space = local perforation (arrow) with marked inflammatory change in the surrounding fat.