Perforated gallbladder empyema with abscesses formation

Case contributed by Dr Ammar Haouimi

Presentation

Right upper quadrant pain with tenderness and fever.

Patient Data

Age: 60 years
Gender: Male

The CT images demonstrate:

  • distended gallbladder with thick enhancing wall and high-attenuating content
  • small stone (9 mm) obstructing the gallbladder-neck well-visualized on non-contrast images
  • multiple defects of the gallbladder wall with fluid collections in subhepatic space, adjacent and within the duodenal wall/hepatic flexure with surrounding fat stranding.
  • dilated common bile duct (10 mm) with stone (8 mm) in its distal portion
  • simple renal cysts

Annotated images:

  • yellow arrow (image A): stone in gallbladder-neck
  • yellow arrow (image B): stone in distal CBD
  • green arrow (image C): abscess of duodenal wall 
  • red arrow (image D): subhepatic abscess adjacent to the colonic wall
  • blue arrow (image E): abscess of colonic wall (hepatic flexure)

Case Discussion

CT features of a perforated gallbladder empyema with formation of adjacent abscesses, extending to the duodenal wall and hepatic flexure

 

Additional contributor: Z.E Boudiaf, CHU, Constantine Algeria

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Case information

rID: 79475
Published: 28th Jun 2020
Last edited: 29th Jun 2020
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria