Acute cholecystitis with gallbladder neck calculus
Diagnosis certain
Updates to Quizquestion Attributes
Answer
was changed:
To determine the impact of the calculi, and to see if there are ductal stones or other obstructions, MRCP (magentic(magnetic resonance cholangiopancreatography) is usually performed. If an intervention is expected, the clinical team may pursue an ERCP.
Updates to Case Attributes
Body
was changed:
This patient presented with RUQright upper quadrant/epigastric pain and tenderness, vomiting and raised inflammatory markers. Although the liver function tests were within normal ranges, ultrasound demonstrated a number of features in keeping with acute cholecystitis (thickened GBgallbladder wall, pericholecystic fluid) as well as potential cause (large calculus in the GBgallbladder neck) and some potential complications (biliary dilatation).
The patient proceeded to MRCP to further characterise this and excluded any ductal stones. MRCP also cleared pancreatic duct involvement, and highlighted the low medial insertion of the cystic duct which is a common normal variant of biliary anatomy but important when considering surgical resection.
-<p>This patient presented with RUQ/epigastric pain and tenderness, vomiting and raised inflammatory markers. Although the liver function tests were within normal ranges, ultrasound demonstrated a number of features in keeping with acute cholecystitis (thickened GB wall, pericholecystic fluid) as well as potential cause (large calculus in the GB neck) and some potential complications (biliary dilatation). </p><p>The patient proceeded to MRCP to further characterise this and excluded any ductal stones. MRCP also cleared pancreatic duct involvement, and highlighted the low medial insertion of the cystic duct which is a common normal variant of biliary anatomy but important when considering surgical resection.</p>- +<p>This patient presented with right upper quadrant/epigastric pain and tenderness, vomiting and raised inflammatory markers. Although the liver function tests were within normal ranges, ultrasound demonstrated a number of features in keeping with acute cholecystitis (thickened gallbladder wall, pericholecystic fluid) as well as potential cause (large calculus in the gallbladder neck) and some potential complications (biliary dilatation). </p><p>The patient proceeded to MRCP to further characterise this and excluded any ductal stones. MRCP also cleared pancreatic duct involvement, and highlighted the low medial insertion of the cystic duct which is a common normal variant of biliary anatomy but important when considering surgical resection.</p>