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Gangrenous cholecystitis

Case contributed by Dr Henry Knipe

Presentation

Right upper quadrant pain.

Patient Data

Age: 35 years
Gender: Female
Ultrasound

Multiple gallstones including one impacted at the gallbladder neck. The gallbladder wall is very thickened measuring up to 19 mm with a "laminated" appearance of the wall. The gallbladder wall is hyperemic in regions although there are areas of absent Doppler signal. Small volume of pelvic free fluid.

Mild fatty liver. No focal hepatic lesion. Mild extrahepatic duct dilatation with the common bile duct measuring 0.6 cm. No choledocholithiasis identified. No intrahepatic duct dilatation. The kidneys, spleen and aorta are within normal limits.

Case Discussion

The patient proceeded to laparoscopic cholecystectomy, which confirmed acute gangrenous cholecysitis. Both the operation and post-operative recovery were uneventful.

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