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Ex vacuo cholesterol gallstones

Case contributed by Dr Maxime St-Amant


Acute abdominal pain.

Patient Data:

Age: 45 Y
Gender: Male
Modality: CT

Many cholelithiasis containing air centrally are seen in the gallbladder.

Incidentally noted are calcified splenic foci likely related to healed granulomatous infection. 

Case Discussion:

Small crevices in the cholelithiasis permits ex vacuo phenomenon of nitrogen gas. Mercedes Benz sign is describes the appearance of the triradiate collection of nitrogen gas. 

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