Presentation
Abdominal pain, vomiting.
Patient Data
Non-distended gallbladder with mildly thickened wall, containing sediment of tiny gallstones, plus several floating gallstones.
Edematous pancreas. Peripancreatic fat stranding and a profuse amount of peripancreatic fluid.
Non-distended gallbladder with reactive wall thickening, containing minuscule nondependent cholesterol gallstones.
Case Discussion
Epigastric pain, vomiting. Clinical signs of peritonitis. Labs: leukocytosis with neutrophilia; total bilirubin 2.1 mg/dL; amylase 2101 IU/L, lipase 6946 IU/L; C-reactive protein 2.37 mg/L (normal). Bedside ultrasound showed a gallbladder with a thickened wall and tiny gallstones, some of them floating. CT abdomen showed signs of interstitial edematous pancreatitis and a gallbladder containing tiny floating gas-density cholesterol gallstones.
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