Presentation
Severe epigastric pain radiating to the back. High serum CRP and lactate. Background of type 2 diabetes.
Patient Data
Rounded lucency in the right upper quadrant likely representing dilated gallbladder.
Serpiginous lucent structure is also seen superiorly to gallbladder which is non specific but may represent air within biliary tree.
See annotated images.
Rounded lucency (white arrows) in the right upper quadrant likely representing dilated gallbladder.
Serpiginous lucent structure (black arrows) also seen superior to gallbladder which is non-specific but may represent air within the biliary tree.
The gallbladder is distended and there is air identified within its wall. Air also seen in the intrahepatic biliary ducts and common bile duct.
Cholelithiasis and mild pericholecystic fat stranding are also observed.
Additionally multiple low attenuation areas within the liver and both kidneys in keeping with infarcts.
The bowel is of normal caliber. No pneumatosis.
Foley catheter in situ.
Case Discussion
Features consistent with emphysematous cholecystitis.
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