File:Acute cholecystitis (Radiopaedia 72392-82923 Axial DWI 94).jpg

Summary:

• Radiopaedia case ID: 72392
• Image ID: 51758651
• Image stack position: 94/120
• Plane projection: Axial
• Aux modality: DWI
• Study findings: There is a 4.5 mm rounded filling defect at the distal end of the common bile duct, at the papilla level, suggestive of intra ductal stone. The CBD is dilated (8.0 mm) and has some inspissated bile within. Mild intra-hepatic dilatation.  No other intraductal stones. The gallbladder is distended and has thick walls showing diffusion restriction consistent with acute cholecystitis. Multiple gallstones. Small amount of free fluid in the superior abdomen. The pancreas has normal morphology and signal intensity, there is no abnormal dilatation of the main pancreatic duct.  The liver has a normal signal intensity.  The spleen, adrenal glands, and kidneys are normal.  There is no lymphadenopathy. Conclusion: 1. Distal 4.5 mm CBD stone and mild biliary tree dilatation. 2. Features consistent with calculous cholecystitis.
• Modality: MRI
• System: Hepatobiliary
• Findings: The gallbladder is distended and edematous with surrounding hyperemia (wall thickness 0.4 cm). Mobile calculi and sludge are present within its lumen.Small volume free fluid in the right upper quadrant. The common bile duct is dilated to 0.8 cm with low-level internal echoes seen throughout its lumen to the level of the ampulla.  No CBD stone identified anywhere along its course.  There is intra-hepatic duct dilatation as seen on the recent CT. The pancreatic duct is not dilated. The main portal vein is patent and demonstrates normal directional blood flow. Conclusion:1. Features in keeping with acute calculus cholecystitis.2. Dilatation of the intra and extrahepatic ducts as seen on CT. The CBD was well visualized with sludge seen throughout its lumen. No evidence of a CBD stone.
• Published: 7th May 2020
• Source: https://radiopaedia.org/cases/acute-cholecystitis-26
• Author: Bruno Di Muzio
• Permission: http://creativecommons.org/licenses/by-nc-sa/3.0/

Licensing:

Attribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0)