Presentation
Sudden pain in the right hypochondrium with spread to the back and feeling flatulence. Patient negates nausea, vomitus and fever. Laboratory analysis: WBC 10,24; RBC 4,7; HGB 135; CRP 1,6.
Patient Data
Ultrasound detects normal distended gallbladder, with two calculus in lumen and diffuse thickening of the wall (up to 5 mm in diameter). Gallbladder wall was irregular thickening at the fundus region, where hypoechoic soft tissue mass were observed which extending into the S 3, 4 and 5 liver parenchyma.
CT confirmed previously established diagnosis of gallbladder carcinoma with liver parenchyma infiltration.
Case Discussion
Gallbladder cancer is a rare malignancy of gastrointestinal tract and may present as acute cholecystitis symptoms. In all elderly patients (especially female) with acute cholecystitis symptoms, we must suspect gallbladder carcinoma, if they have irregular mural thickening or enhancement of wall without regional fat stranding and parameters of inflammation.
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