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Abdominal ultrasound on admission revealed a distended gallbladder, thickening of the gallbladder wall, and biliary sludge (arrowheads).
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It showed a distended gallbladder, thickening of the gallbladder wall, and biliary sludge (Fig. 1).
Abdominal contrast CT on admission demonstrated edematous change of the gallbladder, early patchy enhancement of the liver (arrowheads), and edematous change of the intestinal tract (arrows).
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Abdominal contrast CT examination disclosed edematous change of the gallbladder, early patchy enhancement of the liver, and edematous change of the small intestine (Fig. 2).
Drained purulent bile by percutaneous trans-hepatic gallbladder aspiration puncture.
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Since her high fever persisted despite intravenous levofloxacin of 500 mg/day, percutaneous trans-hepatic gallbladder aspiration puncture (PTGBA) was performed on hospital day 2 to collect 120 mL of purulent bile (Fig. 3).