Acute cholecystitis

Case contributed by Dr Thomas M. Anderson

Presentation

History of cholelithiasis, with worsening right upper quadrant pain.

Patient Data

Age: 75 years
Gender: Female

Hepatobiliary scintigraphy

Nuclear medicine

There is rapid clearance of radiotracer from blood pool, prompt uptake by liver, and no gall bladder visualized after the first 60 minutes of imaging. Bowel is seen, indicating patent common bile duct.

After patient received morphine (0.04 mg/kg), gall bladder was still not seen, compatible with acute cholecystitis.

Case Discussion

Non-visualization of the gall bladder even after morphine administration is compatible with a diagnosis of acute cholecystitis.

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