Acute cholecystitis and ureteric colic

Case contributed by Dr Andrew Dixon

Presentation

Right sided abdominal pain ?renal colic

Patient Data

Age: 50
Gender: Female

Co-existing cholecystitis and right ureteric colic. Findings include pericholecystic fat stranding, right perinephric fat stranding, right hydronephrosis and hydroureter, obstructing stone just proximal to the right vesicoureteric junction, tensile gallbladder fundus sign and Mercedes-Benz sign of air within a gallstone. 

Ultrasound

Ultrasound confirms acute cholecystitis with gallbladder wall thickening, pericholecystic fluid and an impacted stone within the gallbladder neck. Right hydronephrosis due to the ureteric stone is also seen.  

Annotated image

Rare case of co-existing cholecystitis and ureteric colic. Findings include pericholecystic fat stranding (blue dotted arrow), right perinephric fat stranding (yellow dotted arrow), right hydronephrosis (red dotted arrow), stone just proximal to the right vesicoureteric junction (red arrow), tensile gallbladder fundus sign (blue arrows) and Mercedes-Benz sign of air within a gallstone (yellow arrow). 

Case Discussion

A rare case of co-existing acute cholecystitis and obstructing ureteric calculus. Some people are just unlucky! This case includes an excellent example of the tensile gallbladder fundus sign of acute cholecystitis and a reasonable example of the Mercedes-Benz sign of air within a gallstone.    

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Case information

rID: 42330
Case created: 16th Jan 2016
Last edited: 7th Oct 2016
Inclusion in quiz mode: Included

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