Complicated cholecystitis with gallbladder perforation and diffuse acute abdomen

Case contributed by Dr Bruno Di Muzio

Presentation

Right upper abdominal pain.

Patient Data

Age: 90 years
Gender: Male

CT scans shows a distended gallbladder with thick walls and around fat densification. There are also: tortuous and atheromatous aorta; left common iliac artery fusiform aneurism; degenerative spine with scoliosis. 

Patient was hospitalized for supportive care, no immediate indication for surgery. Two days after he developed with abdominal distention and worsening of pain with signs of generalized peritonitis. 

This CT shows a gallbladder perforation associated with an abdominal collection in right iliac fossa (thick walls with enhancement). 

Gallbladder perforation associated with an abdominal collection in right iliac fossa (thick walls with enhancement). 

Case Discussion

The patient presented at emergency department with an acute cholecystitis, getting worse during hospitalization due a gallbladder perforation with peritonitis. 

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