EURORAD ESR

Case 13294

Emphysematous cholecystitis in a diabetic patient

Author(s)
Esther Taberner López. Verónica Ricart Selma.

Hospital Universitario de la Ribera;
Carretera de Corbera, km 1
46600 Alzira, Spain;
Email:etaberner@hospital-ribera.com
 
Patient
female, 71 year(s)
 
 
  • Figure 1
    Abdominal plain film

    Plain film shows curvilinear gas collections in the right upper quadrant (yellow arrows), which represent gas within the gallbladder wall.

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 2
    Abdominal ultrasound

    Transverse US image reveals multiple tiny echogenic reflectors within the gallbladder lumen (red arrows) corresponding to gas bubbles arising from the dependent wall (champagne sign).

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 3
    Abdominal ultrasound

    Transverse US image shows a diffusely echogenic gallbladder wall secondary to intra­mural gas (yellow arrows).

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 4
    Abdominal ultrasound

    Transverse US image showing thickened gallbladder wall (>4mm)

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 5
    Unenhanced CT image

    Axial unenhanced CT image through the upper abdomen demonstrates predominantly intramural gas collections (yellow arrow) and intraluminal gas (red point).

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 6
    Enhanced CT image

    Axial enhanced CT image showing an air–liquid level in the lumen (white thin arrow) and gas in the wall (white thick arrow) of the gallbladder. Extensive pericholecystic inflammation extending the duodenum (red...

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 7
    Enhanced CT image

    Sagittal enhanced CT image. There were no signs of aerobilia nor dilatation of biliary ducts. There were no signs of gallbladder perforation.

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 8
    Enhanced CT image

    Coronal enhanced CT image. Surrounding adipose tissue was reticularly structured extending to the hepatic flexure of the colon (thick arrow). Pericystic fluid collection (thin arrow)

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 9
    Enhanced CT image

    Coronal enhanced CT image shows intraluminal gas consistent with emphysematous changes (green arrow).

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
Plain film shows curvilinear gas collections in the right upper quadrant (yellow arrows), which represent gas within the gallbladder wall.
 
Transverse US image reveals multiple tiny echogenic reflectors within the gallbladder lumen (red arrows) corresponding to gas bubbles arising from the dependent wall (champagne sign).
 
Transverse US image shows a diffusely echogenic gallbladder wall secondary to intra­mural gas (yellow arrows).
 
Transverse US image showing thickened gallbladder wall (>4mm)
 
Axial unenhanced CT image through the upper abdomen demonstrates predominantly intramural gas collections (yellow arrow) and intraluminal gas (red point).
 
Axial enhanced CT image showing an air–liquid level in the lumen (white thin arrow) and gas in the wall (white thick arrow) of the gallbladder. Extensive pericholecystic inflammation extending the duodenum (red arrows).
 
Sagittal enhanced CT image. There were no signs of aerobilia nor dilatation of biliary ducts. There were no signs of gallbladder perforation.
 
Coronal enhanced CT image. Surrounding adipose tissue was reticularly structured extending to the hepatic flexure of the colon (thick arrow). Pericystic fluid collection (thin arrow)
 
Coronal enhanced CT image shows intraluminal gas consistent with emphysematous changes (green arrow).
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version