Presentation
Undifferentiated abdominal pain.
Patient Data
Distended and inflamed gallbladder with wall enhancement discontinuity; in particular, along the interface with the liver (coronal images), where it forms a pericholecystic collection.
Background liver steatosis. Possible tiny left adrenal gland adenoma. The remainder of the viscera are normal.
Gastric band in situ.
Case Discussion
Features of cholecystitis on CT with gallbladder wall discontinuity supporting contained perforation and likely pericholecystic abscess along the interface with liver. Note possible liver hyperemia adjacent to the gallbladder fossa.
It is not uncommon to elderly patient with undifferentiated abdominal pain to undergo CT as the first imaging investigation given quick availability in emergency department.
Percutaneous cholecystostomy guided by US was performed with gallbladder decompression and drainage of pus. US (not shown) confirmed gallbladder wall discontinuity.
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