There is pneumobilia and air within the gallbladder. The gallbladder is contracted and inflamed. The previously seen large gallbladder stone on prior CT (not shown) is no longer in the gallbladder and is likely in the inflamed duodenal bulb. The stomach is distended with fluid. The duodenum and small bowel distal to the bulb are decompressed. Findings likely represent new gallbladder fistula to the duodenal bulb, and a suspected large gallbladder stone has passed into the duodenal bulb causing gastric outlet obstruction.
Cardiomegaly, pulmonary vascular congestion, and small pleural effusions, likely representing congestive heart failure.
Chronic loculated collection in the lower anterior abdominal wall not clinically significant.
Degenerative spine changes.