Case contributed by Chiang Lan


Medical history of gallstones without treatment had acute onset of dull abdominal pain for 2 weeks. He had no fever, nausea, vomiting or diarrhea.

Patient Data

Age: 60 years
Gender: Male

A high density gallstone-in-gallstone with a diameter of 1.5 cm and gallbladder distension with wall thickening and peripheral fat stranding, compatible with acute cholecystitis.

Case Discussion

The patient had an atypical gallstone-in-gallstone. The special structure might be due to recurrence of gallstones formation at different points in time. The previous gallstone was covered layer-by-layer, resulting in a concentric sphere. The patient was discharged after antibiotic treatment and scheduled for a cholecystectomy a month later.

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Case information

rID: 54748
Published: 26th Jul 2017
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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