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Acute cholecystitis and ureteric colic

Case contributed by Dr Andrew Dixon


Right sided abdominal pain ?renal colic

Patient Data

Age: 50 years
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 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

This woman has co-existing acute cholecystitis and ureteric colic. Findings include pericholecystic stranding (blue dotted arrow), perinephric stranding (yellow dotted arrow), hydronephrosis (red dotted arrow), stone just proximal to the right vesicoureteric junction with soft-tissue rim sign (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
Published: 16th Jan 2016
Last edited: 14th Sep 2020
Inclusion in quiz mode: Included

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