c l i n i c a l f o l i o s : n a r r a t i v e





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Gangrenous Gallbladder with Empyema: 1

A D V E R T I S E M E N T

   
 

A 58-year-old woman presented with a 2-day history of increasing right-sided abdominal pain. She had no relevant prior history. Examination showed right-sided tenderness and guarding. Temp. was 101 and white blood cell count was 15k with a left shift. Flat plate showed radio-opaque stones in the right upper quadrant. Ultrasound showed an enlarged gallbladder with wall thickening, pericholecystic fluid, stones and a normal size common duct.      

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Gangrenous Gallbladder with Empyema: 2

A D V E R T I S E M E N T

   
 

CT scan showed an enlarged gallbladder extending almost to the iliac crest (14-cm length) with a stone impacted at the ampulla. Wall thickening and pericholecystic fluid was also seen.       

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Gangrenous Gallbladder with Empyema: 3

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The patient was taken to the operating room for emergency laparoscopic cholecystectomy. Under anesthesia the enlarged gallbladder could be palpated. Upon entering the abdomen through a Hasson umbilical port, there was cloudy free fluid evident.     

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This page was last modified on 5/16/2005.