Presentation
Vomiting and epigastric tenderness.
Patient Data
CT scan without contrast shows thickening of the walls of the gallbladder, small radiopaque stones, stranding of the surrounding fat planes, and small stone (about 6.0 mm) inside the cystic duct. Also, small pleural effusion and atelectasis at the right lung base.
Curved MPR showing the union of the common hepatic duct and the cystic duct and the stone inside the cystic duct.
Case Discussion
Acute cholecystitis represents inflammation of the gallbladder that develops over hours usually due to a gallstone obstructing the extrahepatic biliary tree duct, as shown in this case.
Ultrasound is the first imaging modality of choice when assessing acute biliary tree pathologies. This patient was referred to CT before the blood results, with a broad differential for acute abdomen. As cholecystitis was not specifically suspected, the patient was not initially guided to ultrasound assessment.
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