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Acute Cholecystitis

Sexton JJS - MedPix (2010)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Acute Cholecystitis

History: A 53 year old man presents with continuous burning pain in the right upper quadrant of the abdomen for 4 hours. He reports nausea, but denies vomiting. His last meal was seven hours ago and consisted of "spicy Mexican" food. Past medical history is significant only for GERD.

Findings: The gallbladder wall measures approximately 4mm. There is no evidence of cholelithiasis or pericholecystic fluid. The gallbladder demonstrates dependent layering sludge. There is a 10x9 mm echogenic focus within the dependent portion of the gallbladder without posterior shadowing and demonstrates internal flow. HIDA scan with morphine challenge failed to visualize the gallbladder.

Ddx: Cholecystitis vs. biliary colic vs. gallbladder pathology NOS.

Dxhow: HIDA Scan

Exam: EXAM: -Afebrile with stable vital signs. -Abdominal exam reveals only tenderness to palpation in the RUQ. LABS: -WBC 10.9 -AST/ALT/AlkP: 32 / 56 / 81 -TBili: 0.3

No MeSH data available.


Post morphine challenge image revelas persistent nonvisualization of the gallbladder, suggesting cholecystitis.
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MPX2036_synpic52422: Post morphine challenge image revelas persistent nonvisualization of the gallbladder, suggesting cholecystitis.


Acute Cholecystitis

Sexton JJS - MedPix (2010)

Post morphine challenge image revelas persistent nonvisualization of the gallbladder, suggesting cholecystitis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2036&req=5

MPX2036_synpic52422: Post morphine challenge image revelas persistent nonvisualization of the gallbladder, suggesting cholecystitis.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Acute Cholecystitis

History: A 53 year old man presents with continuous burning pain in the right upper quadrant of the abdomen for 4 hours. He reports nausea, but denies vomiting. His last meal was seven hours ago and consisted of "spicy Mexican" food. Past medical history is significant only for GERD.

Findings: The gallbladder wall measures approximately 4mm. There is no evidence of cholelithiasis or pericholecystic fluid. The gallbladder demonstrates dependent layering sludge. There is a 10x9 mm echogenic focus within the dependent portion of the gallbladder without posterior shadowing and demonstrates internal flow. HIDA scan with morphine challenge failed to visualize the gallbladder.

Ddx: Cholecystitis vs. biliary colic vs. gallbladder pathology NOS.

Dxhow: HIDA Scan

Exam: EXAM: -Afebrile with stable vital signs. -Abdominal exam reveals only tenderness to palpation in the RUQ. LABS: -WBC 10.9 -AST/ALT/AlkP: 32 / 56 / 81 -TBili: 0.3

No MeSH data available.