Presentation
Worsening RUQ abdominal pain.
Patient Data
Cholecystintingraphy was performed displaying adequate radiotracer uptake in the liver with no gallbladder visualization during imaging, consistent with the diagnosis of acute cholecystitis. Tracer visualization in the small intestines indicates no bile duct obstruction.
Case Discussion
This patient presented with worsening RUQ abdominal pain and a history of cholelithiasis raising the suspicion of acute cholecystitis. Other diagnoses in consideration were acute pancreatitis and peptic ulcer disease. Given the high suspicion of acute cholecystitis, a RUQ ultrasound was performed and yielded inconclusive findings.
Ultrasound is typically the preferred diagnostic imaging modality for a patient with RUQ pain as it is more sensitive and readily available than CT and cholescintigraphy. Due to the inconclusive US findings, this patient underwent cholescintigraphy which displayed adequate uptake of the radiotracer in the liver without visualization of the gallbladder. These findings were suggestive of cystic duct obstruction and resulting acute cholecystitis.
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