Diabetic male. C/o fever with acute abdominal pain - 6 - 7 days back. Followed by abdominal heaviness.
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Diffuse odema of gall bladder wall, intraluminal calculus - sludge involving gall bladder.
Well-defined collection abutting right side of body of gall bladder.
Common bile duct is normal in calibre without calculus.
Main pancreatic duct is prominent.
Intraluminal sludge, calculus in odematous gall bladder suggested acute cholecystitis. Pericholecystic loculated collection raised possibility of perforation. Actual breach in wall was not seen.
Surgery after 24 hrs - More than one perforation in gall bladder wall. Pus in gall bladder lumen.