PMC6699282_01
Ultrasound of gallbladder showing inflamed gallbladder with multiple nonmobile stones with shadowing in the gallbladder body. The gallbladder wall is thickened to 0.99 cm. A moderate amount of pericholecystic fluid is identified.
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To exclude cholecystitis, a liver and gallbladder ultrasound. (Figure 1) was performed, revealing multiple nonmobile stones with shadowing noted within the gallbladder sac, a thickened gallbladder wall, and a moderate amount of pericholecystic fluid.
IR-guided cholecystostomy tube placement and drainage and irrigation of the gallbladder with 60 cc of black bile aspiration.
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An ultrasound guided gallbladder drain (Figure 2) was performed.
Indium-111 white blood cell scan showing no localization of abscess and atypical diffuse pulmonary uptake of white blood cells, which can be associated with an opportunistic infection, pulmonary drug toxicity, and sepsis.
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Indium-111 tagged WBC scan was performed (Figure 3) to make sure we have not missed another source of infection.