Demographics:
40 years old, Female
Indication:
Right-sided abdominal pain
Findings
Lower chest
- Mild dependent right basilar atelectasis
Abdomen/Pelvis
- Gallbladder wall thickening and enhancement with mural discontinuity along the ventral margin near the fundus with a contiguous large multiloculated, peripherally-enhancing collection measuring 13 x 8 x 16 cm in the right hepatic lobe involving segments 5 and 6
- Multiple rounded peripherally hyperdense structures in the gallbladder and in the dependent aspect of the hepatic collection consistent with gallstones
- 1.7 cm hypoattenuating lesion in segment 2 of the liver with possible discontinuous peripheral enhancement
- Mild intrahepatic biliary duct dilation
- Small volume free fluid layering in the anatomic pelvis
MSK
- No acute findings
Diagnosis
Perforated acute cholecystitis with hepatic abscess
Sample Report
Findings consistent with perforated acute cholecystitis with a large contiguous right hepatic abscess. Recommend surgical evaluation.
Mild intrahepatic biliary duct dilation likely resulting from mass effect from the large hepatic abscess on the hepatic hilum.
Hypoattenuating structure in the left hepatic lobe may represent a hemangioma or less likely a satellite abscess. This could be further evaluated with ultrasound.
Discussion
References