Presentation
Abdominal pain, fever, nausea and vomiting for 4 days.
Patient Data
Focal round lucency in the right upper quadrant is suggestive of gas outlining the gallbladder wall.
Linear echogenicity outlining the gallbladder wall causing reverberation artifact in keeping with intramural air.
diffuse intramural and intraluminal gas in the gallbladder with gas-fluid level and surrounding pericholecystic fluid
small calculus seen within the gallbladder
mild ascites and periportal edema
minimal bilateral pleural effusion, more on right side
nasogastric tube in place
Case Discussion
Emphysematous cholecystitis carries high mortality and requires prompt diagnosis.
Imaging findings of this patient were conveyed to the surgeon. Open cholecystectomy was performed, which revealed a gangrenous gallbladder wall with purulent material.
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