Acalculous cholecystitis

Case contributed by Christopher Chen
Diagnosis almost certain

Presentation

Immunosuppressed. Febrile with right upper quadrant pain.

Patient Data

Age: 50 years
Gender: Male
ultrasound

Distended gallbladder containing biliary sludge but no cholelithiasis. Marked wall thickening (4-6 mm) and hypervascularity. Pain associated with transducer probe pressure. Intramural edema. Peri-cholecystic fluid.

These findings are consistent with acute acalculous cholecystitis. 

Case Discussion

The patient was immunocompromised from his renal transplant medications and had a complicated COVID-19 infection managed in ICU. Due to his inability to have a cholecystectomy, a percutaneous cholecystostomy was performed as a bridge towards surgery.  

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