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The gallbladder is thickwalled, with significant surrounding fat stranding consistent with inflammation. Near the fundus of the gallbladder the wall is non-enhancing/non-visualised, concerning for perforation. There is a moderate amount of pericholecystic free fluid. Hypodensity within the adjacent liver is concerning for early hepatic abscess formation. No radiopaque stone is demonstrated. No gross intra or extra hepatic duct dilation.
A trace of intra-abdominal free fluid is seen down the right paracolic gutter and in the pelvis. No pneumoperitoneum.
The appearance is consistent with acute cholecystitis, and highly concerning for perforation and early hepatic abscess formation.
The general surgical registrar on call was notified of the findings at 15:40 hours.