Hepatic abscess and hepatic vein thrombosis related to acute cholecystitis

Case contributed by Dr Bruno Di Muzio

Presentation

Diabetic patient with right upper quadrant pain. No fever.

Patient Data

Age: 83
Gender: Male

CT scan shows gallstones and thicker and irregular gallbladder walls associated with a small low-attenuation lesion in the adjacent liver; This lesion seems to be a small collection with faint peripheral enhancement.

There is also a perfusion disturbance at IVA and IVB hepatic segments due a middle hepatic vein thrombus.

Bilateral pleural effusion. 

Case Discussion

The CT findings associated with laboratory and clinical presentation confirm the diagnostic of a complicated cholecystitis (hepatic abscess and middle hepatic vein thrombosis) in a diabetic patient. 

Acute cholecystitis refers to the acute inflammation of the gallbladder. It is the primary complication of cholelithiasis and the most common cause of acute pain in the right upper quadrant.

The main complications of acute cholecystitis include the following1:

 

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Case information

rID: 29604
Case created: 8th Jun 2014
Last edited: 10th Sep 2015
Inclusion in quiz mode: Included

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