Demographics:
72 years old, Male
Indication:
Indication: Right upper quadrant pain, Positive sonogra...
Indication: Right upper quadrant pain, Positive sonographic Murphy sign
Findings
- Gallbladder is distended with marked wall thickening, pericholecystic edema, and multiple layering gallstones
- Focal apparent mural discontinuity at the gallbladder fundus
- No intrahepatic or extrahepatic biliary duct dilation
- Hyperechoic filling defect in the left portal vein with absence of flow on color Doppler evaluation
- Normal appearance of the liver, spleen, kidneys, and urinary bladder
- Visualized portion of the pancreas appears normal
- Visualized segments of the abdominal aorta are normal in caliber
Diagnosis
Gangrenous acute cholecystitis
Portal vein thrombosis
Sample Report
Gallbladder distension, marked wall thickening, pericholecystic edema, multiple layering gallstones, and positive sonographic Murphy sign, consistent with acute cholecystitis. Focal apparent mural discontinuity at the gallbladder fundus is concerning for gangrenous change.
No intrahepatic or extrahepatic biliary duct dilation.
Left portal vein thrombosis. Consider contrast-enhanced CT for further assessment.
Discussion