Acute cholecystitis with gallbladder neck calculus
Diagnosis certain
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Presentation
was changed:
3 days of right upper quadrant and epigastric pain with vomiting. Tender to palpation in RUQright upper quadrant. Raised inflammatory markers but normal liver function tests.
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Findings
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Thickwalled gallbladder (measuring 6mm6 mm) with large calculus obstructing the neck. Sludge in the gallbladder but no other calculi, nor in the ducts. Trace pericholecystic fluid.
Dilated common bile duct (about 8mm8 mm) with intrahepatic biliary dilatation. Patent portal vein.
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Answer
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About 3mm3 mm is considered the upper limit for gallbladder wall thickness. It is important to take time to get the best images for this, as if caught obliquely your measurement will be thicker than it actually is.