PMC7537693_01
Abdominal ultrasound: normal gall bladder with stones without dilatation of the bile duct.
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On abdominal ultrasound, the gallbladder was normal with stones inside, with the biggest size 1.29 cm without dilatation of the bile duct system (Figure 1).
Abdominal CT scan: nonconclusive finding.
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There was also nonconclusive finding on abdominal computed tomography (Figure 2).
Abdominal MRI: (a) gall bladder with the stone inside (arrow) and free peritoneal fluid; (b) no dilatation of the intrahepatic bile duct (IHBD) and extra hepatic bile duct (EHBD).
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MRI was performed due to the jaundice and direct hyperbilirubinemia, and the result showed that there were two gallstones, without dilatation of IHBD and EHBD (Figure 3).
Gall bladder specimen: (a) perforated tract marked with a thread; (b) gall bladder section through the tract.
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On the specimen examination, we found a perforated tract on the fundus of the gallbladder surrounded by the focal necrotic area (Figure 4).