Acute cholecystitis

Case contributed by Dr Bruno Di Muzio

Presentation

Vomiting and epigastric tenderness.

Patient Data

Age: 85
Gender: Male
CT

CT Abdomen

CT scan without contrast shows thickening of the walls of the gallbladder, small radiopaque stones, stranding of the surrounding fat planes, and small stone (about 6.0 mm) inside the cystic duct. Also, small pleural effusion and atelectasis at the right lung base.

Annotated image

Curved MPR showing the the union of the common hepatic duct and the cystic duct and the stone inside cystic duct.

Case Discussion

Acute cholecystitis represents the inflammation of the gallbladder that develops over hours usually due to a gallstone obstructing the extrahepatic biliary tree duct, as shown in this case. 

Ultrasound is the first imaging modality of choice when assessing acute biliary tree pathologies. This patient was referred to CT before the blood results, with a broad differential for acute abdomen, reason why the cholecystitis was not formally suspected and guided to ultrasound assessment. 

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Case information

rID: 17787
Published: 12th May 2012
Last edited: 20th Mar 2018
Inclusion in quiz mode: Included

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