Hepatic abscess and hepatic vein thrombosis related to acute cholecystitis
Diabetic patient with right upper quadrant pain. No fever.
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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.
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.
The main complications of acute cholecystitis include the following1:
- emphysematous cholecystitis
- hemorrhagic cholecystitis
- pericholecystic abscess (this case): as a result of a perforation of the gallbladder wall; hepatic abscesses can also occur