Tubogram
Under fluoroscopic guidance, Omnipaque 240 was injected via the cholecystostomy which remains in situ in the gallbladder lumen. The gallbladder opacified with no filling defects detected. Mural irregularity of the gallbladder is consistent with known cholecystitis. Delayed images demonstrated contrast extravasation from the body of the gallbladder in keeping with perforation. The cystic duct opacified normally. After some delay, contrast entered the common bile duct and duodenum. The common bile and common hepatic ducts opacified normally throughout with no filling defects evident. No intrahepatic or extrahepatic biliary dilatation. Note is made of contrast filling the periampullary duodenal diverticulum demonstrated on CT. The procedure was performed under sterile technique.
Conclusion:
No biliary dilatation or evidence of choledocholithiasis or other source of biliary obstruction. Gallbladder mural irregularity is consistent with known cholecystitis complicated by perforation.