PMC5109577_01
Imaging performed on admission (A-F) and the sixth day of admission (G, H). A, B: Ultrasonography showed marked thickening of the gallbladder wall, a gallstone (A), and pericholecystic fluid (B; arrow), but neither impaction of the stone nor dilatation of the common bile duct was detected. C: Cervical lymphadenopathy (arrows) and D: axial lymphadenopathy (arrows) were detected by contrast-enhanced computed tomography (CT). E, F: Marked thickening of the gallbladder wall (>15 mm) and pericholecystic fluid were detected by CT. G, H: Follow-up CT performed on the sixth day of the admission showed a significant improvement of the gallbladder wall thickening and pericholecystic fluid.
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Cervical and axillary lymphadenopathy, hepatosplenomegaly, marked thickening of the gallbladder wall (>15 mm), pericholecystic fluid, but no signs of intestinal obstruction were detected on computed tomography (CT) and ultrasonography (Fig. 1A-F). A gallstone was also found in the fundus, but neither any impaction of the stone nor dilatation of the common bile duct was detected (Fig. 1A). On the sixth day of admission, follow-up CT revealed a dramatic improvement of the gallbladder wall thickening and pericholecystic fluid (Fig. 1G and H).
Clinical course of our patient. CRP: C-reactive protein, LDH: lactate dehydrogenase, MEPM: meropenem hydrate, mPSL: methylprednisolone, NE: not examined, Plt: platelet count, PSL: prednisolone, rhTM: recombinant human soluble thrombomodulin, T-Bil: total bilirubin, WBC: white blood cell count
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The clinical course is summarized in Fig. 2.