Demographics:
88 years old, Male
Indication:
Vomiting, diarrhea
Findings
Lower chest
- Mild atelectasis/scarring at the lung bases
- Mild cardiomegaly
- Partially imaged pacemaker leads
- Heavy coronary artery and aortic valve calcification
- Small hiatal hernia
Abdomen/Pelvis
- Marked gallbladder distension with diffuse wall thickening, several calcified stones, and extensive pericholecystic inflammatory changes
- 3 mm hyperattenuating structure in the distal common bile duct near the ampulla
- Inflammatory changes extend about colonic diverticula arising from the hepatic flexure
- Trace free fluid tracks from the right upper quadrant inferiorly along the right paracolic gutter
- 8 cm exophytic right lower pole renal cyst. Additional scattered renal hypoattenuating lesions, which are too small to characterize
- Colonic diverticulosis
- Large colonic stool burden
- Atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
- Small right lateral bladder diverticulum
- Peripherally calcified structure in a small left inguinal hernia
- Prostate brachytherapy seeds
MSK
- No acute findings
- Polyarticular degenerative changes
Diagnosis
Acute cholecystitis with choledocholithiasis
Sample Report
Findings consistent with acute cholecystitis and choledocholithiasis with a small stone suspected in the distal common bile duct near the ampulla.
Inflammatory changes about colonic diverticula arising from the hepatic flexure are likely secondary to the adjacent cholecystitis.
Large colonic stool burden, which can be seen with constipation.
Discussion