Presentation
Acute right upper quadrant pain for one week.
Patient Data
Over-distended gallbladder (11.6 x 6.4 cm) with focal wall discontinuity near the gallbladder fundus and focal hypodensity within the liver parenchyma adjacent to the gallbladder likely contained perforation (2.6 x 2.1 cm).
There is evidence of a relatively ring dense focus in the gallbladder neck (1.2 x 1.2 cm) with slight compression over the common hepatic duct and mild prominence intrahepatic ducts.
The common bile duct is not dilated.
The fundus of distended gallbladder abuts the anterior abdominal wall making the so called Tensile gallbladder fundus sign.
Note is made for incidental finding of subcutaneous gluteal region (injection site granulomatous changes)
There is evidence of a relatively ring dense focus in the gallbladder neck (1.2 x 1.2 cm) with slight compression over the common hepatic duct and mild prominence intrahepatic ducts.
Case Discussion
The features are suggestive of acute calculus cholecystitis with wall discontinuity near the gallbladder fundus and focal pericholecystic fluid collection.
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