Vicarious excretion of contrast - gallbladder

Case contributed by Dr Safwat Mohammad Almoghazy

Presentation

A known case of upper oesophagal cancer and a gastrostomy feeding tube inserted 2 weeks back, complaining of pus around the tube? intra-abdominal collection.

Patient Data

Age: 85 years
Gender: Female

Easy flow of contrast ( water-soluble contrast) through the gastrostomy feeding tube to the insertion site with evidence of backflow of contrast around the tube externality.

CT

After 4 days

Note the presence of hyperdense content within the gallbladder lumen.

A post-interventional change seen in the left lateral anterior abdominal wall and reaching to the body of the stomach.

There are edematous left lateral anterior abdominal wall and gas locules between the muscles and fat stranding suggestive of inflammatory process seen in the left lateral anterior abdominal wall.

Multiple surgical clips are seen on the right side for the anterior abdominal wall vertically.

Case Discussion

This patient subjected 4 days back of fluoroscopic study to make insurance of intact gastrostomy tube, and no history any renal or gallbladder disease, then asked CT abdomen to R/O intra-abdominal collection and subjected to CT triphasic protocol and we found in non-enhanced phase their  hyperdense matter in the gallbladder suggesting of vicarious excretion of contrast into its lumen.

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Case information

rID: 54436
Published: 10th Jul 2017
Last edited: 15th Sep 2019
Inclusion in quiz mode: Included

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