Gangrenous cholecystitis

Case contributed by Dr Dalia Ibrahim

Presentation

Right hypochondrial pain, high fever and septicemia.

Patient Data

Age: 60 years
Gender: Male
MRI

Distended gallbladder with mural irregular thickening, ulcerations and sloughing as well as microabscesses showing diffusion restriction. The gallbladder is filled with complex sludge which is likely purulent bile.  

Case Discussion

Gangrenous cholecystitis is a severe advanced type of acute cholecystitis which usually occurs in old men and those with coexisting cardiovascular disease.

It usually occurs secondary to increased intraluminal pressure due to cystic duct obstruction, which results in marked distention of the gallbladder, ischemic necrosis of the wall, and intramural hemorrhage or abscess

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