Perforated gallbladder with bile peritonitis

Case contributed by Nasir Siddiqui
Diagnosis almost certain

Presentation

Severe upper abdominal pain

Patient Data

Age: 65 years

The gallbladder wall is disrupted anteromedially and is in direct communication with a low-attenuation fluid collection tracking superiorly in a perihepatic distribution (scalloping of the underlying liver) and inferiorly along the right paracolic gutter.

The adjacent peritoneum demonstrates abnormal enhancement.

Case Discussion

Perforation of the gallbladder with an associated biloma and findings suggestive of bile peritonitis.

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