Answer of October 1999

Clinical History:

M/67 History of diabetes mellitus. Admitted with RUQ pain and fever.

Figure 1 AXR
Figure 2 AXR(RUQ,36 hours later)

What is your diagnosis?

                            Figure 1

                            Figure 2

                            Figure 3

Diagnosis:

Emphysematous cholecystitis

Discussion:

Figure 1 AXR shows collection of gas with the configuration of gall bladder in the right upper quadrant.

Figure 2 AXR(RUQ, 36 hours later) demonstrates that there is now mottled and curvilinear gas lucencies in the gall bladder region.There is also gas in the cystic duct.

Figure 3 CECT abdomen shows that there is gas in the gall bladder lumen and in the thickened gall bladder wall chacteristic of emphysematous cholecystitis.