Presentation
Abdominal tenderness in RUQ with loss of consciousness.
Patient Data
The gallbladder is distended, a normal enhancing wall of gallbladder body and the fundus is not seen in favor of gangrene and perforation. A spilled gallstone is seen outside the gallbladder lumen within the hepatic bed collection. Other multiloculated air containing collection is seen in segment V and VIII of the liver. No sign of free perforation or peritonitis is seen. The biliary tree seems normal. Despite the proximity to hepatic flexure of colon and duodenum, no sign of fistulization is detected.
Case Discussion
The patient underwent percutaneous drainage of the collection and cholecystostomy catheter insertion and intravenous antibiotic treatment.