Cholecystostomy tube is in situ. The gallbladder is distended, thick walled with moderate surrounding fluid consistent with known cholecystitis. There is heterogeneous mixed signal material in the gallbladder lumen, presumably representing sludge/inflammatory exudate. Sloughed membranes noted. There is no biliary dilation with the common duct measuring 7 mm at the porta hepatis. No convincing filling defect is seen in the duct to suggest choledocholithiasis.
In the liver there are multiple patchy T2 hyperintense and T1 hypointense foci, largest in the segment VII measuring 2.7 cm. These areas correspond to hypoattenuating areas on recent CTs from 15/6/12 and 11/6/12 which on CT appear to be improving on serial scans. These are not clearly abscesses. Mild hepatic steatosis.
Small amount of free fluid is noted around the liver/spleen, left paracolic gutter, within the lesser sac and the Morrison's pouch. There are renal cysts.
Gangrenous Cholecystitis. No choledocholithiasis, biliary dilation or Mirrizzi syndrome.