62-year-old male with history of right upper quadrant pain and elevated white blood cell count. LIVER: No significant abnormalities noted. GALLBLADDER, BILIARY TRACT: Cholelithiasis, with a small amount of gallbladder wall thickening and subtle mural striation. No intrahepatic or extrahepatic biliary dilatation. Common bile duct measures approximately 8 mm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Positive Murphy sign.
Given the patient's acute tenderness, gallbladder wall thickening and mural striation, this is most consistent with acute on chronic cholecystitis.