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The gallbladder is relatively distended with intramural gas and intraluminal air-fluid level. Areas of gallbladder wall defects involving mainly the fundus with extraluminal gas in continuity with an intraperitoneal subdiaphragmatic air-fluid collection. Extensive fat stranding around the gallbladder with thickening and enhancement of the peritoneal reflections. Adjacent inflammatory thickening of the hepatic flexure. Small adjacent hepatic abscesses are noted in segments 4 and 5 well-visualised on post-contrast axial and coronal reformatted images.
Two simple hepatic cysts are noted in the segments, 4 (54 x 24 mm) and 8 (12 x 8 mm), known (discovered a few years ago).
Small right pleural effusion is noted.