Gallbladder perforation secondary to acute cholecystitis
Severe right upper quadrant pain and fever.
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Distended, thick-walled and inflamed gallbladder containing calculi with an interrupted wall at the fundus producing a localized irregular collection of infected bile in the liver parenchyma (arrow).
Gallbladder perforation is a rare complication of acute cholecystitis with a higher morbidity and mortality than conventional gallbladder infection. Diagnosis is often delayed and surgery more complicated as the liver parenchyma is involved.