The CT findings confirmed clinical diagnosis of acute cholecystitis. Due to worsening sepsis, the patient was referred to interventional radiology for percutaneous cholecystostomy.
A. The fundus of the gallbaldder was punctured under ultrasound guidance using an 18 gauge needle. Contrast injection through the needle confirms satisfactory needle position.
B. An 0.035" guide wire was passed through the needle into the gallblader.
C. The tract was dilated with a 10 Fr dilator
D. A 10 Fr pigtail catheter was inserted over the guide wire. Purulent bile was aspirated from the gallbladder, a specimen was sent for microbiological tests.
E. Contrast injection through the drain demonstrates intraluminal filling defects, consistent with gallstones. No contrast is seen to flow through the cystic duct, indicating stone impaction,
F. The gallbladder is decompressed at the end of the procedure.