Acalculous cholecystitis

Case contributed by Dr Thomas Snow

Presentation

Recently diagnosed acute lymphocytic leukaemia, presents pancytopaenic with septic shock and abdominal pain.

Patient Data

Age: 60 years
Gender: Male

Contrast enhanced CT abdomen

Modality: CT

Massively thickened gall bladder wall, dense fluid. No gas in the wall, no stones, no biliary dilatation.

Mild bilateral pleural effusion with right lung lower lobe subsegmental consolidation as well as minimal perihepatic ascites.

Transhepatic cholecystostomy

Modality: Ultrasound

Thick wall gallbladder. No stones within.

Case Discussion

Many operators prefer transhepatic percutaneous cholecystostomy as the risk of bile peritonitis and haemorrhage are less. It gives a good view of the needle pass into the liver, but is often slightly awkward for a right handed operator.

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Case Information

rID: 37090
Case created: 25th May 2015
Last edited: 13th Feb 2017
Tag: gb
Inclusion in quiz mode: Included

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