Presentation
Tender hepatomegaly with fever spikes.
Patient Data
Age: 70 years
Gender: Male
From the case:
Gangrenous cholecystitis
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Overt distension of gall bladder with abnormal mural thickening and edema, a shaggy outline, discontinuity of the mucosa, pericholecystic fat stranding, and hyperemia of the adjacent liver parenchyma. Inferiorly, the wall has been breached with a small fluid collection (likely bile) causing secondary thickening of the hepatic flexure of the colon. No biliary dilatation and no liver abscess.
Case Discussion
These features are highly suggestive of gangrenous cholecystitis with a small localized perforation with a bile fluid collection arising from the fundus.