Acute gangrenous cholecystitis
Right upper quadrant pain and peritonism
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The gallbladder is distended and contains some high-density material. The wall is of variable thickness and density with patchy enhancement. There is pericholecystic fluid and inflammatory change with peritoneal and retroperitoneal fluid, and a right-sided pleural effusion. There are a couple of gallstones, but nothing obstructive in the CBD or head of the pancreas.
Gangrenous cholecystitis is considered the most likely diagnosis because of localized right upper quadrant inflammatory change and patchy gallbladder wall enhancement.
Gangrenous cholecystitis was confirmed operatively.