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Markedly distended gallbladder with non enhancing sections of wall is demonstrated. Over the last three CT scans it has progressively become more distended, and developed areas of non enhancing wall, with associated stranding in the fat surrounding the fundus. In addition there is an increase in the amount of fluid adjacent measuring 7 x 4 x 10cm which as yet does not have enhancing margins.
No free intraperitoneal gas. The liver, spleen, pancreas, kidneys and adrenals are unchanged since previous imaging.
Right pleural effusion is unchanged, right basal atelectasis has progressed. On the left a small pleural effusion has developed and left basal atelectasis is now demonstrated.