Acute gangrenous cholecystitis

Case contributed by Dr Jeremy Jones

Presentation

Right upper quadrant pain and peritonism

Patient Data

Age: 65 years
Gender: Female

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.

Case Discussion

Gangrenous cholecystitis was confirmed operatively. 

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