PMC5379072_01
CT abdomen pelvis day 2: periportal and pericholecystic fat stranding with hyperaemia of the extrahepatic bile duct and adjacent stranding. Findings are suspicious for an ascending cholangitis and cholecystitis.
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fig1
A CT of the abdomen and pelvis showed periportal and pericholecystic fat stranding with hyperaemia of the extrahepatic bile duct with adjacent stranding (Figure 1).
CT abdomen pelvis day 6: air within a distended gall bladder with persistent pericholecystic fat stranding, more marked than on prior imaging and extending to involve the hepatic flexure. New, peripherally enhancing fluid collection extending the inferior tip of the liver along the right paracolic gutter; appearances are suggestive of complicated cholecystitis with a gallbladder perforation.
CRIGM2017-1971457.002.jpg
PMC5379072_01_CRIGM2017-1971457.002.jpg
fig2
On day 6, a repeat CT abdomen demonstrated air within a distended gall bladder, with persistent pericholecystic fat stranding, extending to involve the hepatic flexure and a peripherally enhancing fluid collection in the right paracolic gutter (Figure 2).