Acute calcular cholecystitis

Case contributed by Mohammadtaghi Niknejad


Abdominal pain and vomiting.

Patient Data

Age: 50 years
Gender: Female



The gallbladder is markedly distended up to 75 mm and shows increased wall thickness and enhancement; accompanied by pericholecystic inflammatory fat stranding. Multiple small low signal filling defects are seen in gallbladder inferring stones. An impacted stone is also observed at the cystic duct.

Extra and central intrahepatic bile ducts are dilated and CBD measured 11 mm in caliber with homogeneous internal signal intensity and abrupt distal cut-off.

A 25 mm midline fascial defect is present at the anterior abdominal wall that some omental fat herniated through it.

Case Discussion

Features on MRI are compatible with acute cholecystitis with impacted stones at the cystic duct. Impacted distal CBD stone is also suspected.

MRI is sensitive in the detection of acute cholecystitis, with findings similar to those seen on ultrasound and CT. MR cholangiopancreatography (MRCP) may show an impacted stone in the gallbladder neck or cystic duct as a rounded filling defect.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.