Presentation
Right upper quadrant pain, fever
Patient Data
Ultrasound demonstrates gallbladder wall thickening with a "laminated" appearance, pericholecystic fluid, sonographic Murphy sign, an obstructing stone in the gallbladder neck (not shown).
Asymmetrical wall thickness with ulceration (red arrow).
US-guided cholecystostomy was performed. Black and thick bile was obtained from gallbladder drainage.
A cholecystectomy will perform some days later the presentation.
Courtesy of Dr Nguyen Van Cong
Case Discussion
US findings are consistent with acute cholecystitis. Especially, asymmetrical wall thickness with ulceration is suggestive of the gangrenous gallbladder.
Percutaneous cholecystostomy, which is a safe and effective procedure in high-risk patients was done until the stabilization of a patient to enable a more measured surgical approach.
Unable to process the form. Check for errors and try again.